HAN SAM CORP (NPI# 1689823486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689823486 |
| Entity Type | Organization |
| Organization Name | HAN SAM CORP |
| Other Organization Name | RIVER'S EDGE PHARMACY |
| Practice Address |
36919 Cook St Ste 102 Palm Desert CA 92211-6069 |
| Mailing Address |
36919 Cook St Suite 102 Palm Desert CA 92211-6069 |
| Practice Telephone | 7603403248 |
| Practice Fax Number | 7603403258 |
| Mailing Telephone | 7603403248 |
| Mailing Fax Number | 7603403258 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2017-12-21 |
| Authorized Official Name | HANY BENJAMIN (CEO) |
| Authorized Official Telephone | 7603403248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | PHY49157 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2117821 | 01 | |
| CA | 1689823486 | 05 |
| Other Name | Type Code |
|---|---|
| River's Edge Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861050502 | Han Sam Corp | Clinic/Center | 300 Sierra College Dr Ste 250, Grass Valley, CA 95945-5083 | 2019-05-29 |
| 1770081887 | Han Sam Corp | Clinic/Center | 7177 Brockton Ave Ste 341, Riverside, CA 92506-2634 | 2018-01-24 |
| 1508315128 | Han Sam Corp | Durable Medical Equipment & Medical Supplies | 17332 Von Karman Ave Ste 110, Irvine, CA 92614-6280 | 2016-09-23 |
| 1396182853 | Han Sam Corp | Pharmacy | 2571 W La Palma Ave., # A, Anaheim, CA 92801 | 2013-05-23 |
| 1669895231 | Han Sam Corp | Pharmacy | 35400 Bob Hope Dr Ste 207, Rancho Mirage, CA 92270-1774 | 2014-02-01 |
| Street Address |
36919 COOK ST STE 102 |
| City | PALM DESERT |
| State | CA |
| Zip Code | 92211-6069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467950006 | Mireille Hakim | Pharmacist | 36919 Cook St Ste 102, Palm Desert, CA 92211-6069 | 2018-01-29 |
| 1437670726 | Nina T Lor | Pharmacist | 36919 Cook St Ste 102, Palm Desert, CA 92211-6069 | 2017-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780293936 | Childnet Youth and Family Services, Inc. | Community/Behavioral Health | 42-600 Cook Street, Suite 100, Palm Desert, CA 92211 | 2020-07-23 |
| 1003457607 | Catherine Krumplitsch | Technician | 41430 Kansas Street, Palm Desert, CA 92211 | 2019-10-04 |
| 1942702055 | Executive Recovery Group, Inc | Clinic/Center | 77725 Enfield Ln # 100-200, Palm Desert, CA 92211 | 2018-03-05 |
| 1992248918 | West Coast Surgery Inc | Orthopaedic Surgery | 36915 Cook Street, Suite 103 B, Palm Desert, CA 92211 | 2016-11-22 |
| 1063963098 | Therese Tudor | Physical Therapist | 77-682 Country Club Drive, Suite G, Palm Desert, CA 92211 | 2016-10-14 |
| 1609249663 | John D Rasmussen | Anesthesiology | 160 Running Spring Drive, Palm Desert, CA 92211 | 2015-11-12 |
| 1033580113 | Executive Recovery Group, Inc | Substance Abuse Rehabilitation Facility | 35450 Pegasus Ct, Palm Desert, CA 92211 | 2015-10-14 |
| 1861862146 | Artur Sarkisyan | Dentist | 34-460 Monterey Ave Ste 100, Palm Desert, CA 92211 | 2015-09-30 |
| 1649686833 | Annamaria Valenzuela | Licensed Vocational Nurse | 77-777 Country Club Drive, Apt 235, Palm Desert, CA 92211 | 2014-07-08 |
| 1265876759 | Guardian Angel Home Care, Inc. | Home Health | 41865 Boardwalk, Suite 215, Palm Desert, CA 92211 | 2013-04-26 |
| Find all providers in zip 92211 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316207665 | Desertrx Pharmacy | Pharmacy | 73091 Country Club Dr Ste A4, Palm Desert, CA 92260-2338 | 2012-05-21 |
| 1427285618 | Kaiser Foundation Health Plan Inc | Pharmacy | 75036 Gerald Ford Dr Fl 1 Rm 152f, Palm Desert, CA 92211-2080 | 2009-06-16 |
| 1669970828 | Cornerstone Pharmacy Services LLC | Pharmacy | 39575 Washington St Ste 103, Palm Desert, CA 92211-4152 | 2018-01-23 |
| 1447787114 | Cornerstone Pharmacy Services, LLC. | Pharmacy | 39575 Washington St Ste 103, Palm Desert, CA 92211-4152 | 2017-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
| City | PALM DESERT |
| Zip Code | 92211 |
Please comment or provide details below to improve the information on HAN SAM CORP.
| 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.