OrganizationActive
Mendocino Pharmacy Holdings Inc.
NPI 1205453586 · Community/Retail Pharmacy · Gualala, CA
Mendocino Pharmacy Holdings Inc. is a Community/Retail Pharmacy organization in Gualala, CA (NPI 1205453586).
Provider details
- NPI number
- 1205453586
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kelly Brodetsky, President, Director(707) 734-0091
Specialties & taxonomies
Suppliers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
39251 South Highway 1
Gualala, CA 95445
Phone: (707) 734-0091
Fax: (707) 962-3011
Street-level locationGet directions
Mailing address
Po Box 904
Mendocino, CA 95460-0904
Other names (DBA / former)
- Doing business as
- Gualala Community Pharmacy
Registry dates
- Enumerated
- 2020-07-02
- Last updated
- 2020-07-02
- Certified
- 2020-07-02
Frequently asked questions
- What is Mendocino Pharmacy Holdings Inc.'s NPI number?
- Mendocino Pharmacy Holdings Inc.'s National Provider Identifier (NPI) is 1205453586, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mendocino Pharmacy Holdings Inc.?
- Mendocino Pharmacy Holdings Inc. is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Mendocino Pharmacy Holdings Inc. located?
- Mendocino Pharmacy Holdings Inc.'s practice location on file with NPPES is 39251 South Highway 1, Gualala, CA 95445.
- What is Mendocino Pharmacy Holdings Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Mendocino Pharmacy Holdings Inc. is (707) 734-0091.
- Who is the authorized official for Mendocino Pharmacy Holdings Inc.?
- The authorized official listed on Mendocino Pharmacy Holdings Inc.'s NPPES record is Kelly Brodetsky, President, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mendocino Pharmacy Holdings Inc.'s NPI active?
- Yes — Mendocino Pharmacy Holdings Inc.'s NPI (1205453586) is active in the NPPES registry as of the last update on 2020-07-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.