LARK REXALL DRUGS INC (NPI# 1750484820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750484820 |
| Entity Type | Organization |
| Organization Name | LARK REXALL DRUGS INC |
| Other Organization Name | LARK DRUGS PHARMACY |
| Practice Address |
16251 Main St Guerneville CA 95446-8300 |
| Practice Telephone | 7078699055 |
| Practice Fax Number | 7078699203 |
| Mailing Telephone | 7078699055 |
| Mailing Fax Number | 7078699203 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2015-03-25 |
| Authorized Official Name | MRS. AMALIA NICOLA (PRESIDENT/OWNER) |
| Authorized Official Telephone | 7078699055 |
| Authorized Official Credential | PHARMACY TECH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PHY 51871 | CA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY 51871 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PROVIDER NUMNER | 1750484820 | 01 |
| CA | CALIFORNIA STATE BOARD OF PHARMACY LICENSE | PHY 51871 | 01 |
| CA | MEDICARE (IMMUNIZATIONS) | 135347 | 01 |
| Other Name | Type Code |
|---|---|
| LARK DRUGS PHARMACY | Doing Business As Name - Organization |
| Street Address |
16251 MAIN ST |
| City | GUERNEVILLE |
| State | CA |
| Zip Code | 95446-8300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407331937 | Nicole Lauren Nahigian | Pharmacist | 16251 Main St, Guerneville, CA 95446-8300 | 2018-10-01 |
| 1285024166 | Ann Blancke | Pharmacist | 16251 Main St, Guerneville, CA 95446-8300 | 2015-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659840387 | Thomas N Tiffer | Taxi | 14701 Canyon 7 Rd, Guerneville, CA 95446 | 2018-11-26 |
| 1265969059 | Teresa Bowden | Counselor | 16255 1st Street, Guerneville, CA 95446 | 2017-05-11 |
| 1255882502 | Skye Ashley | Marriage & Family Therapist | 16390 Main Street, Guerneville, CA 95446 | 2016-10-21 |
| 1326461187 | Christopher Arthur Newell | Pharmacist | 16251 Main St., Lark Drugs, Guerneville, CA 95446 | 2014-01-30 |
| 1750658159 | Daryl Wolfe | Pharmacist | 16405 River Rd, Guerneville, CA 95446 | 2011-11-30 |
| 1881995041 | Declan Gerard Prendergast | Pharmacist | 16405 River Rd., Guerneville, CA 95446 | 2010-11-04 |
| 1154523272 | West County Community Services | Community/Behavioral Health | 14520 Armstrong Woods Rd, Guerneville, CA 95446 | 2007-06-01 |
| 1912128661 | Raymond Francis Skryja | Dentist | 14001 Old Cazadero Rd, Guerneville, CA 95446 | 2007-05-01 |
| 1598786352 | West County Health Centers, Inc. | Clinic/Center | 16312 Third Street, Guerneville, CA 95446 | 2006-07-21 |
| 1255365532 | Suzanne Kay Saville | Dentist | 16312 3rd Street, Guerneville, CA 95446 | 2006-07-10 |
| Find all providers in zip 95446 | ||||
| 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] |
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| Find all providers with the same taxonomy | ||||
| City | GUERNEVILLE |
| Zip Code | 95446 |
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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.