MARAVICH ENTERPRISES (NPI# 1790116861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790116861 |
| Entity Type | Organization |
| Organization Name | MARAVICH ENTERPRISES |
| Other Organization Name | HIDDEN VALLEY PHARMACY |
| Practice Address |
19851 Hartmann Rd Unit C Hidden Valley Lake CA 95467-8307 |
| Practice Telephone | 7079873995 |
| Practice Fax Number | 7079873120 |
| Mailing Telephone | 7079873995 |
| Mailing Fax Number | 7079873120 |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2015-08-04 |
| Authorized Official Name | MICHAEL MARAVICH (MANAGING MEMBER) |
| Authorized Official Telephone | 7079873995 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY51432 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 3765640 | 05 | |
| PK | 2143179 | 01 |
| Other Name | Type Code |
|---|---|
| Hidden Valley Pharmacy | Doing Business As Name - Organization |
| Street Address |
19851 HARTMANN RD UNIT C |
| City | HIDDEN VALLEY LAKE |
| State | CA |
| Zip Code | 95467-8307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790806602 | Marvich Enterprises, LLC | Pharmacy | 19851 Hartmann Road, Suite C, Hidden Valley Lake, CA 95467 | 2007-04-02 |
| 1982730800 | Adventist Health California Medical Group, Inc. | Specialist | 18990 Coyote Valley Road, Suite 8, Hidden Valley Lake, CA 95467 | 2007-02-26 |
| 1154571636 | Adventist Health California Medical Group, Inc. | Psychiatry & Neurology | 18990 Coyote Valley Road, Suite 8, Hidden Valley Lake, CA 95467 | 2008-09-22 |
| 1992003602 | Laura Nichols | Midwife | 17921 Moon Hill Ct, Hidden Valley Lake, CA 95467-8097 | 2011-03-03 |
| 1457764466 | Betty Lue Lieber | Counselor | 17664 Greenridge Rd, Hidden Valley Lake, CA 95467-8275 | 2014-06-06 |
| 1194927327 | Maureen Frances Brown | Nurse Practitioner | 19400 Dallas Ct # B, Hidden Valley Lake, CA 95467-8325 | 2007-06-01 |
| 1598398711 | Lisa Cuff | Nurse Practitioner | 19558 Donkey Hill Rd, Hidden Valley Lake, CA 95467-8332 | 2020-02-17 |
| 1710584388 | Lake Health Services, Inc. | Pharmacy | 18990 Coyote Valley Rd Ste 2&3, Hidden Valley Lake, CA 95467-8337 | 2020-10-06 |
| 1578860722 | Adventist Health Physicians Network | Internal Medicine | 18990 Coyote Valley Rd, Suite 9, Hidden Valley Lake, CA 95467-8337 | 2011-02-24 |
| 1558737486 | Adventist Health Clearlake Hospital Inc | Clinic/Center | 18990 Coyote Valley Rd, Hidden Valley Lake, CA 95467-8337 | 2015-08-14 |
| Find all providers in zip 95467 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584388 | Lake Health Services, Inc. | Pharmacy | 18990 Coyote Valley Rd Ste 2&3, Hidden Valley Lake, CA 95467-8337 | 2020-10-06 |
| 1306156096 | Ruth A Stewart | Pharmacy | 18990 Coyote Valley Rd Ste 2, Hidden Valley Lake, CA 95467-8339 | 2010-10-14 |
| 1790806602 | Marvich Enterprises, LLC | Pharmacy | 19851 Hartmann Road, Suite C, Hidden Valley Lake, CA 95467 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | HIDDEN VALLEY LAKE |
| Zip Code | 95467 |
Please comment or provide details below to improve the information on MARAVICH ENTERPRISES.
| 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.