KIDNEYCARE RX INC (NPI# 1225292816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225292816 |
| Entity Type | Organization |
| Organization Name | KIDNEYCARE RX INC |
| Practice Address |
2944 S Norfolk St San Mateo CA 94403-2018 |
| Mailing Address |
1350 Old Bayshore Hwy Suite 777 Burlingame CA 94010-1823 |
| Practice Telephone | 6503491451 |
| Practice Fax Number | 6503492570 |
| Mailing Telephone | 6506968900 |
| Mailing Fax Number | 8662084462 |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2008-07-14 |
| Authorized Official Name | MR. JOSHUA M GOLOMB (VICE PRESIDENT) |
| Authorized Official Telephone | 6506968900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | PHY47005 | CA | Suppliers |
| N | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
PHY47005 | CA | Suppliers |
| N | 333600000X | Pharmacy | PHY47005 | CA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY47005 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHA470050 | 05 |
| Street Address |
2944 S NORFOLK ST |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94403-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520903 | Happy Enerqi LLC | Acupuncturist | 5 43rd Ave, San Mateo, CA 94403 | 2019-10-21 |
| 1740840396 | Vincent Wing Ching Fong | Marriage & Family Therapist | 2600 S. El Camino Real Suite 200, San Mateo, CA 94403 | 2019-06-17 |
| 1861056426 | Denise Gaytan | Licensed Vocational Nurse | 2600 El Camino, San Mateo, CA 94403 | 2019-04-29 |
| 1134686991 | Connie Markoff | Counselor | 3827 Fernwood St, San Mateo, CA 94403 | 2019-02-27 |
| 1467965392 | Happyqi Inc | Acupuncturist | 5 43rd Ave., San Mateo, CA 94403 | 2017-11-14 |
| 1710403092 | John Luu | Chiropractor | 3153 Campus Dr, San Mateo, CA 94403 | 2017-08-17 |
| 1477009033 | Latifunisa Lilani | Community Health Worker | 2600 El Camino Real, San Mateo, CA 94403 | 2016-09-01 |
| 1881029874 | Juan Carlos Friesen | Licensed Vocational Nurse | 2600 S. El Camino, Suite #200, San Mateo, CA 94403 | 2013-09-09 |
| 1619300423 | Emily Rodda | Nurse Practitioner | 222 W. 39th Avenue, San Mateo Medical Center - Pediatric Clinic, San Mateo, CA 94403 | 2013-08-15 |
| 1619309549 | Maria Lucila Echeverria-bustios | Counselor | 1911 Ivy St., San Mateo, CA 94403 | 2013-08-02 |
| Find all providers in zip 94403 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205982543 | Ted's Village Pharmacy Inc. | Pharmacy | 29 W 25th Ave, San Mateo, CA 94403-2236 | 2007-01-27 |
| 1013951458 | Longs Drug Stores California LLC | Pharmacy | 77 Bovet Rd, San Mateo, CA 94402-3104 | 2006-06-16 |
| 1013951847 | Longs Drug Stores California LLC | Pharmacy | 872 N Delaware St, San Mateo, CA 94401-1504 | 2006-06-15 |
| 1336182161 | Longs Drug Stores California LLC | Pharmacy | 4242 S El Camino Real, San Mateo, CA 94403-5133 | 2006-06-13 |
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|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.