NPIMap

Organization Active NPI

Imgrx SJ Valley, Inc.

  • Community/Retail Pharmacy
  • Parlier, CA
National Provider Identifier
1013024132
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
54519 Issued in CA
Legal business name
IMGRX SJ VALLEY, INC.
Practice address
429 E Manning Ave BLDG 1
Parlier, CA 93648-2668
Phone
(559) 646-3561
Fax
(559) 646-6916
NPI assigned
Aug 24, 2006
Organization subpart
Yes
Parent organization
IMGRX SJ VALLEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Michael Brown
Title
Vice President, Managed Services
Phone
(281) 749-4764

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 54519 CA Primary

Addresses

Primary practice location

429 E Manning Ave BLDG 1
Parlier, CA 93648-2668

Mailing address

Attn: CHC Retail Pharmacy Dept. 13651 Dublin CT
Stafford, TX 77477
Phone (281) 749-4000

Other identifiers 1

IdentifierTypeStateIssuer
PHA198030MedicaidCA

Other names 1

  • United Health Centers Parlier Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imgrx SJ Valley Inc11 organizations share this tax ID, including this one
Part of
Imgrx SJ Valley Inc

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

429 E Manning Ave
Bldg 1
Parlier, CA 93648
Phone (559) 646-3561

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1013024132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: CHC RETAIL PHARMACY DEPT. 13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "281-749-4000",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 E MANNING AVE BLDG 1",
            "city": "PARLIER",
            "state": "CA",
            "postal_code": "936482668",
            "telephone_number": "559-646-3561",
            "fax_number": "559-646-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMGRX SJ VALLEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMGRX SJ VALLEY, INC.",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED SERVICES",
        "authorized_official_telephone_number": "281-749-4764"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA198030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Health Centers Parlier",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "United Health Centers Parlier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parlier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.