Medicine Shoppe 917

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MEDICINE SHOPPE 917

Doing business as

Medicine Shoppe

Practice address

3507 W Walnut Ave
Visalia, CA 93277-4170

Phone

(559) 625-5015

Fax

(559) 625-1987

NPI assigned

Aug 31, 2006

Last updated

Mar 7, 2023By 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

Peter K Kwok

Title

Partner

Phone

(559) 625-5015

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Medicine Shoppe 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.

• Amanda Kwok Chiang

  • Pharmacist
  • Visalia, CA
  • NPI 1154852986
  NPD (past)
• Cheryl Chin Kwok, PHARM.D.

  • Pharmacist
  • Visalia, CA
  • NPI 1235654658
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1023120953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 W WALNUT AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774170",
            "telephone_number": "559-625-5015",
            "fax_number": "559-625-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 W WALNUT AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774170",
            "telephone_number": "559-625-5015",
            "fax_number": "559-625-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE SHOPPE 917",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KWOK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "559-625-5015"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY40626",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "0593497",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA406260",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0593497",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Michael Medeiros, PHARMD
• Monica Medel
• Medical Arts Ambulatory Surgery Center
• Medical Support Los Angeles a Medical Corporation
• Medication Time Pharmacy Consulting (Medication Time Consulting)
• Diana Marcela Medina-Rangel, DDS
• Aaliyah Reyes Medina
• Gabriel Alexander Medina
• Isabela Medina
• Mandy Medina, PHARM.D.

• Community/Retail Pharmacy in Visalia, CA
• Providers in Visalia, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.