Provider Demographics
NPI:1982064549
Name:NORTH EAST MEDICAL SERVICES
Entity Type:Organization
Organization Name:NORTH EAST MEDICAL SERVICES
Other - Org Name:NEMS - CLEMENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-391-9686
Mailing Address - Street 1:1019 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2112
Mailing Address - Country:US
Mailing Address - Phone:415-391-9686
Mailing Address - Fax:415-599-2857
Practice Address - Street 1:1019 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2112
Practice Address - Country:US
Practice Address - Phone:415-352-5182
Practice Address - Fax:415-599-2857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CA536613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158318OtherPK