NPIMap

Organization Active NPI

North East Medical Services

  • Community/Retail Pharmacy
  • San Francisco, CA
National Provider Identifier
1992747109
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY 40315 Issued in CA
Legal business name
NORTH EAST MEDICAL SERVICES
Practice address
1520 Stockton St
San Francisco, CA 94133-3354
Phone
(415) 391-9686
Fax
(415) 391-9704
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Dr. Eddie Chan, PHARM.D.
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY 40315 CA Primary

Addresses

Primary practice location

1520 Stockton St
San Francisco, CA 94133-3354

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

Other identifiers 3

IdentifierTypeStateIssuer
1992747109MedicaidCA
PHY 40315OtherCASTATE LIC: BD OF PHARMACY
0592522OtherNCPDP PREVIOUSLY NABP

Other names 1

  • North East Medical Services Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201026001202 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4284520529 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Daly City, CA; San Francisco, CA; San Jose, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
North East Medical Services57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1798 19th Ave
San Francisco, CA 94122

728 Pacific Ave
Ste 403
San Francisco, CA 94133

1715 Lundy Ave
Ste 1082116
San Jose, CA 95131

Practitioners & affiliated clinicians

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1992747109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686",
            "fax_number": "415-433-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686",
            "fax_number": "415-391-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY 40315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992747109",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC: BD OF PHARMACY",
            "identifier": "PHY 40315",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PREVIOUSLY NABP",
            "identifier": "0592522",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North East Medical Services Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.