1. Home
  2. Directory
  3. California
  4. Chula Vista
  5. Pharmacy
  6. NPI Profile
  7. NPI Record 1730202425

RITEAID 5614
Complete NPI Record 1730202425
Pharmacy - Community/Retail Pharmacy in Chula Vista, CA

NPI Status: Active since April 09, 2007

Contact Information

740 OTAY LAKES RD
CHULA VISTA, CA
ZIP 91910
Phone: (619) 421-4872
Fax: (619) 421-2452

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Middle Name
  24. Authorized Official Title or Position
  25. Authorized Official Telephone Number
  26. Healthcare Provider Taxonomy Code 1
  27. Provider License Number 1
  28. Provider License Number State Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Is Organization Subpart
  31. Authorized Official Name Prefix Text
  32. Authorized Official Credential Text

Complete NPI Dataset

This page represents the complete record for NPI 1730202425. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1730202425
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Line Business Mailing Address: 740 OTAY LAKES RD
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Business Mailing Address City Name: CHULA VISTA
The first name of the provider, if the provider is an individual.
Provider Business Mailing Address State Name: CA
The middle name of the provider, if the provider is an individual.
Provider Business Mailing Address Postal Code: 921046915
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Mailing Address Country Code If outside U S : US
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Telephone Number: 6194214872
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address Fax Number: 6194212452
The city name in the mailing address of the provider being identified.
Provider First Line Business Practice Location Address: 740 OTAY LAKES RD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Practice Location Address City Name: CHULA VISTA
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Practice Location Address State Name: CA
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Practice Location Address Postal Code: 919106915
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address Country Code If outside U S : US
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Telephone Number: 6194214872
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Fax Number: 6194212452
The city name in the location address of the provider being identified.
Provider Enumeration Date: 4/9/2007
The State code in the location of the provider being identified.
Last Update Date: 8/22/2020
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Authorized Official Last Name: SOUSA
The country code in the location address of the provider being identified.
Authorized Official First Name: PEDRO
The telephone number associated with the location address of the provider being identified.
Authorized Official Middle Name: MIGUEL
The middle name of the authorized official.
Authorized Official Title or Position: PHARMACY MANAGER
The title or position of the authorized official.
Authorized Official Telephone Number: 6194214872
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 3336C0003X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 42230
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: CA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
Authorized Official Credential Text: PHARM.D.