Organization Active NPI

Ceuticare LLC

Doing business as Regal Specialty Pharmacy

  • Long Term Care Pharmacy
  • Corona, CA
National Provider Identifier
1942952122
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CEUTICARE LLC
Doing business as
Regal Specialty Pharmacy
Practice address
1875 California Ave Ste 101
Corona, CA 92881-6477
Phone
(951) 817-1005
NPI assigned
Jan 19, 2022
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Shirley PhamNPI 1407571631
Title
Owner/Pharmacy Manager
Phone
(951) 817-1005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

1875 California Ave Ste 101
Corona, CA 92881-6477

Mailing address

1875 California Ave Ste 101
Corona, CA 92881-6477
Phone (951) 817-1005

Other identifiers 1

IdentifierTypeStateIssuer
57876OtherCACALIFORNIA BOARD OF PHARMACY

Other names 1

  • Regal Specialty Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1875 California Ave
Ste 101
Corona, CA 92881
Phone (951) 817-1005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1942952122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 CALIFORNIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928816477",
            "telephone_number": "951-817-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 CALIFORNIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928816477",
            "telephone_number": "951-817-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEUTICARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "OWNER/PHARMACY MANAGER",
        "authorized_official_telephone_number": "951-817-1005"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF PHARMACY",
            "identifier": "57876",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regal Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.