Acariahealth Pharmacy 13 Inc
Organization Active NPI Specialty Pharmacy · Commerce, CA
NPI 1992786495 · NPPES record last updated Aug 21, 2022
Key facts
- NPI
- 1992786495
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialty Pharmacy 3336S0011X
- Legal business name
- ACARIAHEALTH PHARMACY 13 INC
- Practice address
- 3302 Garfield Ave
Commerce, CA 90040 - Phone
- (323) 262-9403
- Fax
- (866) 834-8523
- NPI assigned
- Nov 10, 2005
- Organization subpart
- No
Authorized official
- Name
- Stephen Jensen
- Title
- President
- Phone
- (800) 511-5144
Practitioners 3
-
Kenneth L. Hobbs, D.P.M.
-
Felicita Mojica-Olson, PHARMACIST
-
Carol Rim, PHARM.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120801000388 | CA | Part B Supplier - Pharmacy | 6103022009 | Practice locations: Commerce, CA |
National Provider Directory
Locations
3302 Garfield Ave
Commerce, CA 90040
Phone (323) 262-9403
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Agency | 251F00000X | |||
| Specialty Pharmacy | 3336S0011X | Yes |
Addresses
Primary practice location
3302 Garfield Ave
Commerce, CA 90040
Mailing address
8517 Southpark Cir Ste 200
Orlando, FL 32819-9033
Phone (855) 422-2742
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200925580A | Medicaid | IN | |
| 1992786495 | Medicaid | ID | |
| 1028407 | Medicaid | AK | |
| 2133836 | Other | PK | |
| 11979100 | Medicaid | FL | |
| 1992786495 | Medicaid | UT | |
| 709279 | Medicaid | AZ | |
| 1992786495 | Medicaid | CA | |
| 630914 | Medicaid | HI | |
| 1992786495 | Medicaid | MN | |
| 1992786495 | Medicaid | MT | |
| 2947066 | Medicaid | OH | |
| 6031785 | Medicaid | WA | |
| 1992786495 | Medicaid | OR |
Other providers in Commerce, CA
- Glenn W Abel
- Aziza F Abraham
- Olivia Abrams
- Kaylee Aburto
- Acariahealth Pharmacy 13 Inc
- Erika Aceves
- Stepanie Ackerman
- Noelle Adames
- Adelante Therapy
- Adolescent Growth, Inc
All providers in Commerce, CA · Specialty Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.