Active NPI
Fred and Lucy Inc
- Community/Retail Pharmacy
- Rancho Cucamonga, CA
National Provider Identifier
1043356652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 41665
- Legal business name
- FRED AND LUCY INC
- Practice address
- 9700 19TH St
Suite a
Rancho Cucamonga, CA 91737-3538 - Phone
- (909) 989-2002
- Fax
- (909) 989-1182
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Fred Lee, R PH
- Title
- Owner
- Phone
- (909) 989-2002
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 41665 | CA | Primary |
Addresses
Primary practice location
9700 19TH St
Suite a
Rancho Cucamonga, CA 91737-3538
Mailing address
9700 19TH St
Suite a
Rancho Cucamonga, CA 91737-3538
Phone (909) 989-2002
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0579562 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| PHA416650 | Medicaid | CA |
Other names 1
- RX 2 GO
National Provider Directory
National Provider DirectoryLocations
9700 19th St
Ste A
Rancho Cucamonga, CA 91737
Phone (909) 989-2002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1321574400000",
"number": "1043356652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9700 19TH ST",
"address_2": "SUITE A",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917373538",
"telephone_number": "909-989-2002",
"fax_number": "909-989-1182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9700 19TH ST",
"address_2": "SUITE A",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917373538",
"telephone_number": "909-989-2002",
"fax_number": "909-989-1182"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRED AND LUCY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-30",
"last_updated": "2011-11-18",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "FRED",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "909-989-2002",
"authorized_official_credential": "R PH"
},
"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": "41665",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "0579562",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHA416650",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RX 2 GO",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.