VLS Clayworth Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY51452 Issued in CA

Legal business name

VLS CLAYWORTH PHARMACY INC

Doing business as

Clayworth Healthcare Pharmacy

Practice address

20353 Lake Chabot Rd
Ste 101
Castro Valley, CA 94546-5392

Phone

(510) 537-9402

Fax

(510) 537-1487

NPI assigned

Aug 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sudhir Reddy, PHARMDNPI 1043761877

Title

Owner

Phone

(510) 537-9402

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Clayworth Healthcare Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudhir Reddy, PHARM D

  • Ambulatory Care Pharmacist
  • Castro Valley, CA
  • NPI 1043761877
  NPD Authorized official
• Christopher Corzine, PHARMD

  • Pharmacist
  • Castro Valley, CA
  • NPI 1326496795
  NPD (past)
• Roberto Gonzalez Jr.

  • Pharmacist
  • Castro Valley, CA
  • NPI 1760331656
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1942319702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14183 CATALINA ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775509",
            "telephone_number": "510-352-5400",
            "fax_number": "510-352-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20353 LAKE CHABOT RD",
            "address_2": "STE 101",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465392",
            "telephone_number": "510-537-9402",
            "fax_number": "510-537-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VLS CLAYWORTH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-537-9402",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY51452",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141315",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clayworth Healthcare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Villanueva Guadarrama
• Isabelle Riate Villar
• Vision Gallery Optometric Center
• Vision Gallery Optometric Ctr
• VLS Clayworth Pharmacy Inc (Clayworth Pharmacy)
• Phuong Dai Vo, MD
• Nightsnow Vogt
• Ezekiel Volkert, M.D.
• Shannon Wagner
• Walgreen Co (Walgreens #00101)

• Community/Retail Pharmacy in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.