Palmdale Medical Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

PALMDALE MEDICAL PHARMACY INC

Doing business as

Palmdale Medical Pharmacy

Practice address

540 W. Palmdale Blvd.
#A
Palmdale, CA 93551-4232

Phone

(661) 267-2638

Fax

(661) 267-0813

NPI assigned

Jun 16, 2005

Last updated

Dec 3, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Poojan Vachhani

Title

Ceo/Cfo/Sec./Dir.

Phone

(661) 267-2638

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PALMDALE MEDICAL PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hsiao Tung Ho, RPH

  • Pharmacist
  • Palmdale, CA
  • NPI 1952470304
  NPD (past)
• Ivan Law, RPH

  • Pharmacist
  • Palmdale, CA
  • NPI 1083063473
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1003811134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W. PALMDALE BLVD.",
            "address_2": "#A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514232",
            "telephone_number": "661-267-2638",
            "fax_number": "661-267-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W. PALMDALE BLVD.",
            "address_2": "#A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514232",
            "telephone_number": "661-267-2638",
            "fax_number": "661-267-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMDALE MEDICAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2024-12-03",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "VACHHANI",
        "authorized_official_first_name": "POOJAN",
        "authorized_official_title_or_position": "CEO/CFO/SEC./DIR.",
        "authorized_official_telephone_number": "661-267-2638"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA466440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALMDALE MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PALMDALE MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.