Provider Demographics
NPI:1114974797
Name:PHARMACY ALTERNATIVES CALIFORNIA, LLC
Entity Type:Organization
Organization Name:PHARMACY ALTERNATIVES CALIFORNIA, LLC
Other - Org Name:COTTONWOOD DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2100
Mailing Address - Street 1:805 N WHITTINGTON PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-7101
Mailing Address - Country:US
Mailing Address - Phone:502-394-2100
Mailing Address - Fax:
Practice Address - Street 1:20635 GAS POINT RD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:CA
Practice Address - Zip Code:96022
Practice Address - Country:US
Practice Address - Phone:530-347-3721
Practice Address - Fax:530-347-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY43430332B00000X, 332BX2000X, 3336C0003X, 3336L0003X, 3336M0002X, 335E00000X
CAPHY47451332B00000X, 333600000X, 3336I0012X, 3336M0002X
CAPHY43403336M0003X
CAPHY 47451335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA434300Medicaid
CA0530938OtherNCPDP
CAFP8236881OtherUS DOJ
CAPHY57109OtherBOARD OF PHARMACY
CAPHA434300Medicaid
CA0530938OtherNCPDP