PARK MEDICAL PHARMACY (NPI# 1508970849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508970849 |
| Entity Type | Organization |
| Organization Name | PARK MEDICAL PHARMACY |
| Other Organization Name | MEDICAL CENTER PHARMACY |
| Practice Address |
855 3rd Ave Ste 1102 Chula Vista CA 91911 |
| Mailing Address |
610 Gateway Center Way Ste A San Diego CA 92102-4533 |
| Practice Telephone | 6195850665 |
| Practice Fax Number | 6195850591 |
| Mailing Telephone | 6195850665 |
| Mailing Fax Number | 6195850591 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2015-09-22 |
| Authorized Official Name | MR. GEORGE AWAD (OWNER) |
| Authorized Official Telephone | 6192624373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | PHY 44794 | CA | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | RPH42751 | CA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHA447940 | 05 | |
| CA | PHARMACY DEA | BM7185893 | 01 |
| CA | PHARMACY LICENSE | PHY44794 | 01 |
| Other Name | Type Code |
|---|---|
| Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669779435 | Park Medical Pharmacy | Pharmacy | 750 Medical Center Ct, Ste 1, Chula Vista, CA 91911-6634 | 2011-02-14 |
| 1891808127 | Park Medical Pharmacy | Pharmacist | 610 Gateway Center Way, Suite A, San Diego, CA 92102-4533 | 2006-08-17 |
| 1700999034 | Park Medical Pharmacy | Pharmacist | 610 Gateway Center Way, Suite A, San Diego, CA 92102-4533 | 2006-08-17 |
| 1588672562 | Park Medical Pharmacy | Pharmacist | 610 Gateway Center Way, Ste A, San Diego, CA 92102-4533 | 2006-08-04 |
| Street Address |
855 3RD AVE STE 1102 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915594 | Adla Tessier | Internal Medicine | 855 3rd Ave, Chula Vista, CA 91911-1350 | 2005-07-08 |
| 1538572540 | Merrilyn Robinson | Pharmacist | 855 3rd Ave, #4430, Chula Vista, CA 91911-1354 | 2014-06-06 |
| 1598081820 | Maria Ana Argoud | Physician Assistant | 855 3rd Ave, Chula Vista, CA 91911-1354 | 2010-04-12 |
| 1922235662 | Reina Abeyta | Nurse Practitioner | 855 3rd Ave, Chula Vista, CA 91911-1354 | 2009-06-21 |
| 1114183308 | Carl Joesph Hemesath | Dentist | 855 3rd Ave, Suite 3330, Chula Vista, CA 91911-1354 | 2008-08-06 |
| 1629251855 | Adla D. Tessier, Md, Inc | Specialist | 855 3rd Ave, Suite #3300, Chula Vista, CA 91911-1354 | 2007-12-11 |
| 1083742639 | Georges M. Argoud, M.d. | Internal Medicine | 855 3rd Ave, Suite 2210, Chula Vista, CA 91911-1354 | 2007-03-02 |
| 1750335113 | Charles Howard Bowden | Pediatrics | 855 3rd Ave, 4400, Chula Vista, CA 91911-1350 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011064 | Hfm Inc | Pharmacy | 750 Medical Center Court, Suite 8, Unit A, Chula Vista, CA 91911 | 2020-07-24 |
| 1659991198 | Cindy Way | Student in an Organized Health Care Education/Training Program | 1161 Bay Blvd. Ste. B Chula Vista,ca 91911, Chula Vista, CA 91911 | 2020-04-24 |
| 1083243455 | Uriel Angel Gonzalez | Student in an Organized Health Care Education/Training Program | 1161 Bay Boulevard B, Chula Vista, Chula Vista, CA 91911 | 2020-04-07 |
| 1083252464 | Denisse Patricia Macias | Dentist | 235 East Orange Avenue, Apartment E4, Chula Vista, CA 91911 | 2019-12-16 |
| 1952955494 | Jenifer Irene Wright | Counselor | 1180 Third Ave Suite C-3, Chula Vista, CA 91911 | 2019-08-01 |
| 1891357075 | Myriam Lourdes Scales | Counselor | 1172 3rd Ave Suite D1, Chula Vista, CA 91911 | 2019-07-08 |
| 1295228328 | Centro De Salud De La Comunidad De San Ysidro, Inc | Clinic/Center | 880 Third Ave Ste A, Chula Vista, CA 91911 | 2018-06-13 |
| 1902398589 | The Arc of San Diego | Day Training, Developmentally Disabled Services | 1280 Nolan Avenue, Chula Vista, CA 91911 | 2018-05-31 |
| 1003344292 | Jalitza Cardona | Peer Specialist | 853 3rd Ave, Suite C, Chula Vista, CA 91911 | 2017-06-01 |
| 1598138042 | Amy Nylund | Nurse Practitioner | 754 Medical Center Ct Ste 100, Chula Vista, CA 91911 | 2015-11-05 |
| Find all providers in zip 91911 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801417704 | Jay N Surati | Pharmacist | 2084 Otay Lakes Rd Ste 102, Chula Vista, CA 91913-1368 | 2020-05-01 |
| 1730727454 | Aimee Joy Trammell | Pharmacist | 555 Broadway Ste 1054, Chula Vista, CA 91910-5345 | 2019-12-12 |
| 1871130823 | Andrew Thak Tha Yip | Pharmacist | 1320 La Crescentia Dr, Chula Vista, CA 91910-7942 | 2019-12-09 |
| 1134777139 | Shawki Marrogi Bachoua | Pharmacist | 79 E Emerson St, Chula Vista, CA 91911-3547 | 2019-09-03 |
| 1205395597 | Victor J Wahba | Pharmacist | 1637 Third Ave Unit A, Chula Vista, CA 91911-5823 | 2019-03-15 |
| 1598221004 | Louis Valentin | Pharmacist | 480 4th Ave Ste 100, Chula Vista, CA 91910-4411 | 2019-02-20 |
| 1730695230 | Michael Edward Brown | Pharmacist | 1038 Abeto Ct, Chula Vista, CA 91910-8002 | 2017-12-19 |
| 1891209151 | Douglas Martin Faucher | Pharmacist | 384 H St # 100, Chula Vista, CA 91910-5513 | 2017-11-24 |
| 1831627207 | Hong Xuan Nguyen | Pharmacist | 1376 Third Ave, Chula Vista, CA 91911-4303 | 2017-05-30 |
| 1396270583 | Tam Trieu | Pharmacist | 555 Broaway Suite 1054, Chula Vista, CA 91910 | 2017-04-25 |
| Find all providers in CHULA VISTA | ||||
| City | CHULA VISTA |
| Zip Code | 91911 |
Please comment or provide details below to improve the information on PARK MEDICAL PHARMACY.
| 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.