FIDELIS HEALTH GROUP LLC (NPI# 1316135569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316135569 |
| Entity Type | Organization |
| Organization Name | FIDELIS HEALTH GROUP LLC |
| Other Organization Name | FIDELIS SPECIALTY PHARMACY |
| Practice Address |
1002 S Baldwin Ave Arcadia CA 91007-7234 |
| Practice Telephone | 6264472138 |
| Practice Fax Number | 6264476433 |
| Mailing Telephone | 6264472138 |
| Mailing Fax Number | 6264476433 |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2018-09-20 |
| Authorized Official Name | WAGNER A LEMUS (PRESIDENT) |
| Authorized Official Telephone | 7028150800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
PHY52510 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1316135569 | 05 | |
| PK | 2149274 | 01 |
| Other Name | Type Code |
|---|---|
| Fidelis Specialty Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255761128 | Fidelis Health Group LLC | Pharmacy | 5275 Arville St Ste 156, Las Vegas, NV 89118-4937 | 2013-11-13 |
| Street Address |
1002 S BALDWIN AVE |
| City | ARCADIA |
| State | CA |
| Zip Code | 91007-7234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760896021 | Garry Chan | Pharmacist | 1002 S Baldwin Ave, Arcadia, CA 91007-7234 | 2014-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982174504 | Ying Zhang | Nurse Practitioner | 301 Huntington Dr., Suite 607, Arcadia, CA 91007 | 2018-11-26 |
| 1891287819 | Sunflower Tcm Health Center | Acupuncturist | 650 Weat Duarte Road, # 168, Arcadia, CA 91007 | 2018-06-05 |
| 1326537911 | Natural Health Care Inc | Clinic/Center | 1434 S Baldwin Ave, Arcadia, CA 91007 | 2018-05-09 |
| 1720590458 | Shokoofeh Namiranian | Pharmacist | 745 E. Naomi Ave, Arcadia, CA 91007 | 2017-11-03 |
| 1164897351 | The One Dental Specialty Center Inc | Dentist | 1245 W. Huntington Drive, #207, Arcadia, CA 91007 | 2015-12-14 |
| 1366815771 | Jackie Liang Zhang Sr. | Acupuncturist | 650 West Duarte Road, # 168, Arcadia, CA 91007 | 2015-11-06 |
| 1811379365 | Michael Bastani | Podiatrist | 289 W Huntington Dr Ste 204, Arcadia, CA 91007 | 2015-06-22 |
| 1740661776 | Albert Tsuyuan Wang | Emergency Medicine | 531 Magellan Rd, Arcadia, CA 91007 | 2015-06-16 |
| 1740678176 | Karina Herrera | Behavioral Analyst | 444 W. Huntington Dr., #211, Arcadia, CA 91007 | 2015-01-08 |
| 1356751614 | H-light Global Inc | Acupuncturist | 1245 W Huntington Dr #212, Arcadia, CA 91007 | 2014-05-07 |
| Find all providers in zip 91007 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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] |
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| 1699227983 | Landmark Pharma Inc | Pharmacy | 1113 Alta Ave Ste 100, Upland, CA 91786-2804 | 2016-11-02 |
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| 1659824837 | Borrego Community Health Foundation | Pharmacy | 68555 Ramon Rd Bldg D, Cathedral City, CA 92234-3310 | 2016-07-25 |
| 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.