Medicine Shoppe

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY224260 Issued in CA

Legal business name

MEDICINE SHOPPE

Practice address

300 W Shaw Ave Ste 114
Clovis, CA 93612-3680

Phone

(559) 297-0251

Fax

(559) 297-4251

NPI assigned

Aug 31, 2006

Reactivated

May 29, 2008

Organization subpart

No

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

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

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.

• Darren Lew, PHARMD

  • Pharmacist
  • Clovis, CA
  • NPI 1437308780
  NPD (past)
• Shelley Lew, PHARMD

  • Pharmacist
  • Clovis, CA
  • NPI 1023266731
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1982716809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W SHAW AVE STE 114",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W SHAW AVE STE 114",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123680",
            "telephone_number": "559-297-0251",
            "fax_number": "559-297-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE SHOPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-05-29",
        "deactivation_date": "2008-04-30",
        "reactivation_date": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY224260",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0575247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark David McOmber, LCSW
• Judith Lynn Meadows, RD
• Krysta Pilar Meany, PSYD
• Medequip, Inc
• Medical Support Los Angeles a Medical Corporation
• Lizet Medina Delgado
• Robin D Medina-Reinhart, NP, FNP
• Adam Jacob Medina
• Medsurge
• Caitlin Reiman Mehrtash, RD

• Pharmacy in Clovis, CA
• Providers in Clovis, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.