NPIMap

Organization Active NPI

Sama Healthcare Inc

Doing business as Fullerton Express Pharmacy

  • Pharmacy
  • Fullerton, CA
National Provider Identifier
1023665494
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SAMA HEALTHCARE INC
Doing business as
Fullerton Express Pharmacy
Practice address
105 W Bastanchury Rd Ste D
Fullerton, CA 92835-2525
Phone
(714) 500-7727
NPI assigned
Aug 21, 2019
Last updated
Jan 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Authorized official

Name
Samah IbrahimNPI 1841831088
Title
Pic/Ceo
Phone
(714) 500-7727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

105 W Bastanchury Rd Ste D
Fullerton, CA 92835-2525

Mailing address

191 Groveland
Irvine, CA 92620-2826
Phone (805) 720-4563

Other names 1

  • Fullerton Express Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201216000937 CA Part B Supplier - Pharmacy 9931528064 Practice locations: Fullerton, CA

National Provider Directory

National Provider Directory
Tax ID family
Fullerton Express Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1023665494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 GROVELAND",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202826",
            "telephone_number": "805-720-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W BASTANCHURY RD STE D",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352525",
            "telephone_number": "714-500-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMA HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SAMAH",
        "authorized_official_title_or_position": "PIC/CEO",
        "authorized_official_telephone_number": "714-500-7727"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fullerton Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.