Organization Active NPI

JMC Pharmacy, Inc.

Doing business as abc pharmacy

  • Community/Retail Pharmacy
  • Riverside, CA
National Provider Identifier
1023493244
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
52548 Issued in CA
Legal business name
JMC PHARMACY, INC.
Doing business as
abc pharmacy
Practice address
3907 Chicago Ave Ste a
Riverside, CA 92507-5367
Phone
(909) 415-3131
Fax
(909) 415-3268
NPI assigned
Jul 29, 2015
Last updated
Dec 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Dr. Jonathan Chan, PHARMDNPI 1750923595
Title
Owner
Phone
(909) 285-1118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 52548 CA Primary

Addresses

Primary practice location

3907 Chicago Ave Ste a
Riverside, CA 92507-5367

Mailing address

3907 Chicago Ave Ste a
Riverside, CA 92507-5367
Phone (909) 415-3131

Other identifiers 2

IdentifierTypeStateIssuer
58794OtherCABOARD OF PHARMACY
1023493244MedicaidCA

Other names 1

  • abc pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210216003004 CA Part B Supplier - Pharmacy 2062827421 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Riverside, CA; Ontario, CA; Rancho Cucamonga, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2920 Inland Empire Blvd
Ste 112
Ontario, CA 91764
Phone (909) 291-3800

3907 Chicago Ave
Ste A
Riverside, CA 92507
Phone (909) 415-3131

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1023493244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 CHICAGO AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925075367",
            "telephone_number": "909-415-3131",
            "fax_number": "909-415-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 CHICAGO AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925075367",
            "telephone_number": "909-415-3131",
            "fax_number": "909-415-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMC PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-285-1118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "52548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "58794",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023493244",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "abc pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "abc pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.