ST KEROLLOS PHARMACY INC (NPI# 1992716583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992716583 |
| Entity Type | Organization |
| Organization Name | ST KEROLLOS PHARMACY INC |
| Other Organization Name | JUELLE AND LIMA PHARMACY |
| Practice Address |
4566 Florence Ave Ste 9 Cudahy CA 90201-4345 |
| Practice Telephone | 3235621577 |
| Practice Fax Number | 3237335140 |
| Mailing Telephone | 3235621577 |
| Mailing Fax Number | 3237335140 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2017-03-24 |
| Authorized Official Name | BASSEM HENEIN (CEO) |
| Authorized Official Telephone | 3235621578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY54607 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1992716583 | 05 | |
| PK | 2166511 | 01 |
| Other Name | Type Code |
|---|---|
| JUELLE AND LIMA PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306344858 | St Kerollos Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 111 E Carson St Ste B, Carson, CA 90745-7722 | 2018-01-30 |
| 1922283621 | St Kerollos Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 4566 Florence Ave, Ste 4, Bell, CA 90201-4345 | 2008-01-02 |
| Street Address |
4566 FLORENCE AVE STE 9 |
| City | CUDAHY |
| State | CA |
| Zip Code | 90201-4345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912964255 | Lydia Cavales Oftadeh | Specialist | 4566 Florence Ave, Suite 4, Cudahy, CA 90201-4345 | 2006-04-28 |
| 1932536802 | Laarni Gutierrez-darvin Md Inc | Pediatrics | 4566 Florence Ave, Cudahy, CA 90201-4345 | 2013-10-08 |
| 1356658611 | Lovato Family Optometric Center, Inc. | Optometrist | 4566 Florence Ave, Ste. 6, Cudahy, CA 90201-4345 | 2010-09-08 |
| 1134447089 | Marco A. Martinez, M.d. Inc | Internal Medicine | 4566 Florence Ave, Suite #5, Cudahy, CA 90201-4345 | 2010-05-17 |
| 1700924909 | Marco A Martinez | Internal Medicine | 4566 Florence Ave, Suite # 5, Cudahy, CA 90201-4345 | 2007-02-01 |
| 1851497911 | Casimiro Gonzalez | Ophthalmology | 4566 Florence Ave, #3, Cudahy, CA 90201-4345 | 2006-09-16 |
| 1316983422 | Victoria Ann Lovato | Optometrist | 4566 Florence Ave, Ste 6, Cudahy, CA 90201-4347 | 2006-06-20 |
| 1073570248 | Bertha Olivia Alarcon-vargas | Dentist | 4566 Florence Ave, Suite 7, Cudahy, CA 90201-4345 | 2006-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073087235 | St Jude Medical Center | Clinic/Center | 4946 E Florence Ave, Bell, CA 90201 | 2019-01-21 |
| 1912404708 | Zoe Kiklis | Dentist | 7903 Atlantic Ave Ste G, Cudahy, CA 90201 | 2018-04-09 |
| 1508373002 | Ki Baek Lee, Dds. Inc. | Dentist | 6501 Eastern Ave., #b, Bell Gardens, CA 90201 | 2018-01-05 |
| 1003289299 | Ching-yi Chiu | Nurse Practitioner | 6513 S Garfield Ave, Bell Gardens, CA 90201 | 2015-11-10 |
| 1215310008 | Family Health Care Centers of Greater Los Angeles, Inc. | Clinic/Center | 6119 Agra St., Bell Gardens, CA 90201 | 2015-06-30 |
| 1932506201 | Helen Van | Nurse Practitioner | 6501 S. Garfield Ave, Bell Gardens, CA 90201 | 2014-12-02 |
| 1558768358 | Behrooz Zinati Dds Inc | Dentist | 7607 Atlantic Ave., Cudahy, CA 90201 | 2014-11-24 |
| 1205230661 | Aditi Mathur | Dentist | 6320 E.florence Ave, Suite G, Bell Gardens, CA 90201 | 2014-10-14 |
| 1487075461 | Yang H Kim Dds Inc | Dentist | 4021 Florence Ave, Bell, CA 90201 | 2013-12-18 |
| 1265706261 | Patricia Walker | Health Maintenance Organization | 6533 Carmelita Ave, Bell, CA 90201 | 2012-03-08 |
| Find all providers in zip 90201 | ||||
| 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 |
|---|---|---|---|---|
| 1730659962 | Hayat Pharmacy 12 | Pharmacy | 5911 S Packard Ave, Cudahy, WI 53110-3025 | 2018-11-30 |
| 1346281219 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 5740 S Packard Ave, Cudahy, WI 53110-2659 | 2006-06-09 |
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| 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 | ||||
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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.