RODERICK PHARMACY GROUP INC (NPI# 1396726634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396726634 |
| Entity Type | Organization |
| Organization Name | RODERICK PHARMACY GROUP INC |
| Other Organization Name | RX EXPRESS |
| Practice Address |
711 E Market St Stockton CA 95202-3104 |
| Mailing Address |
Po Box 1651 Stockton CA 95201-1651 |
| Practice Telephone | 2094651001 |
| Practice Fax Number | 2099461001 |
| Mailing Telephone | 2094651001 |
| Mailing Fax Number | 2099461001 |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2013-09-13 |
| Authorized Official Name | DAVID RODERICK (CEO) |
| Authorized Official Telephone | 2094651001 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHY43891 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 1992342 | 01 | |
| CA | PHA438910 | 05 |
| Other Name | Type Code |
|---|---|
| RX EXPRESS | Doing Business As Name - Organization |
| Street Address |
711 E MARKET ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95202-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376087890 | David N. Roderick | Pharmacist | 711 E Market St, Stockton, CA 95202-3104 | 2016-12-19 |
| 1093175739 | Maribel Parra | Pharmacist | 711 E Market St, Stockton, CA 95202-3104 | 2016-02-23 |
| 1720232663 | Alena Marie White | Pharmacist | 711 E Market St, Stockton, CA 95202-3104 | 2008-11-05 |
| 1891834826 | Jack B. Grider | Pharmacist | 711 E Market St, Stockton, CA 95202-3104 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
| 1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
| 1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
| Find all providers in zip 95202 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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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| 1205394673 | Bruce Enterprise LLC | Pharmacy | 123 S Commerce St Ste A, Stockton, CA 95202-2837 | 2019-03-05 |
| 1073983144 | Bjrx Pharmacy Ltc Inc | Pharmacy | 1801 E March Ln # 270, Stockton, CA 95210-6629 | 2015-10-01 |
| 1124127691 | Zumwalt Pharmacy Inc | Pharmacy | 19 Public Sq, Stockton, MO 65785-7617 | 2006-09-21 |
| 1699285973 | Bunnaun Uch | Pharmacy | 4555 N Pershing Ave Ste 7, Stockton, CA 95207-6739 | 2017-10-02 |
| 1306939749 | Bunnaun Uch | Pharmacy | 4555 N Pershing Ave, Ste 7, Stockton, CA 95207-6740 | 2006-09-30 |
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| 1265077283 | Western Pharmacy Group LLC | Pharmacy | 610 Gateway Center Way Ste H-i, San Diego, CA 92102-4533 | 2019-11-13 |
| 1083255129 | Desert Best Pharmacy, Inc. | Pharmacy | 170 E Tahquitz Canyon Way, Palm Springs, CA 92262-6431 | 2019-09-30 |
| 1538718838 | Xpress Med Pharmacy Inc | Pharmacy | 16929 Bushard St, Fountain Valley, CA 92708-2819 | 2019-09-09 |
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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.