OPTUM PHARMACY 806, INC. (NPI# 1295746709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295746709 |
| Entity Type | Organization |
| Organization Name | OPTUM PHARMACY 806, INC. |
| Practice Address |
2288 Auburn Blvd Ste 102 Sacramento CA 95821-1619 |
| Practice Telephone | 8887923888 |
| Practice Fax Number | 8885543299 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | DAVID OBERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 9529361300 |
| Is Organization Subpart | Y |
| Parent Organization Name | APOTHECARY HOLDINGS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY48218 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8082292 | 05 | |
| MT | 1295746709 | 05 | |
| WA | 2001488 | 05 | |
| OR | 500638816 | 05 | |
| NV | 1295746709 | 05 | |
| WA | 6032080 | 05 | |
| CA | PHA482180 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | OPTUM PHARMACY 806, INC. | 24416 N 19th Ave, Phoenix, AZ 85085-1887 |
| Street Address |
2288 AUBURN BLVD STE 102 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-1619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134734155 | David Rhyoo | Pharmacist | 2288 Auburn Blvd Ste 102, Sacramento, CA 95821-1619 | 2020-09-15 |
| 1891272357 | Nicholas Van Groningen | Pharmacist | 2288 Auburn Blvd Ste 102, Sacramento, CA 95821-1619 | 2018-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| 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 |
|---|---|---|---|---|
| 1811517535 | Natomas Pharmacy, Inc. | Pharmacy | 4321 Truxel Rd Ste F1, Sacramento, CA 95834-3753 | 2020-04-22 |
| 1124647011 | Innova Pharmacy II | Pharmacy | 3701 J St Ste 101, Sacramento, CA 95816-5542 | 2020-04-11 |
| 1225667181 | Raley's | Pharmacy | 4690 Freeport Blvd, Sacramento, CA 95822 | 2020-04-03 |
| 1740820133 | Innova Pharmacy IIi | Pharmacy | 2400 Glendale Ln Ste A, Sacramento, CA 95825-2431 | 2020-01-14 |
| 1154962967 | Pillbox, Inc. | Pharmacy | 3941 J St Ste 130, Sacramento, CA 95819-3628 | 2019-10-02 |
| 1942869656 | Hoang Pharmacy Inc. | Pharmacy | 8701 Center Pkwy Ste 150, Sacramento, CA 95823-7920 | 2019-06-07 |
| 1104380252 | Ahcs Specialty Care LLC | Pharmacy | 1820 Tribute Rd Ste G, Sacramento, CA 95815-4307 | 2019-01-23 |
| 1689125403 | Xpress Care Pharmacy | Pharmacy | 4241 Florin Rd Ste 50a, Sacramento, CA 95823-2535 | 2016-10-17 |
| 1275987885 | Good Heart Pharmacists | Pharmacy | 1740 Fruitridge Rd # 104, Sacramento, CA 95822-3067 | 2016-04-20 |
| 1619273687 | Capitol Pharmacy Inc | Pharmacy | 4220 Florin Rd # 111, Sacramento, CA 95823-2508 | 2011-02-08 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
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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.