Organization Active NPI

Fred and Lucy Inc

  • Community/Retail Pharmacy
  • Rancho Cucamonga, CA
National Provider Identifier
1043356652
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
41665 Issued in CA
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

Updated by the provider on Nov 18, 2011

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0579562OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHA416650MedicaidCA

Other names 1

  • RX 2 GO Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.