Central Drug Store

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CENTRAL DRUG STORE

Practice address

4494 Mission St
San Francisco, CA 94112-1950

Phone

(415) 585-0111

Fax

(415) 585-9006

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jerrold Steven Tonelli, RPH

Title

Pharmacist/Owner

Phone

(415) 585-0111

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Central Drug Co Inc Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647648000000",
    "number": "1992817027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121950",
            "telephone_number": "415-585-0111",
            "fax_number": "415-585-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121950",
            "telephone_number": "415-585-0111",
            "fax_number": "415-585-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A",
        "authorized_official_last_name": "TONELLI",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "415-585-0111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "38147",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PH0A18520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Drug Co Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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