Western Pharmacy Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55910 Issued in CA

Legal business name

WESTERN PHARMACY GROUP LLC

Practice address

3904 Park Blvd
San Diego, CA 92103-3502

Phone

(619) 295-3109

Fax

(619) 295-6478

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Kevin Faris

Title

Ceo

Phone

(360) 220-4818

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDICAL CENTER PHARMACY Doing business as

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1063671535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 COHO WAY STE 312",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252066",
            "telephone_number": "360-685-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033502",
            "telephone_number": "619-295-3109",
            "fax_number": "619-295-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PHARMACY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "FARIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-220-4818"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175999",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Western Dental Services, Inc.
• Western Dental Services, Inc.
• Western Health Private Homecare
• Western Health Resources
• Western Health Resources
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC

• Community/Retail Pharmacy in San Diego, CA
• Providers in San Diego, 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 Jul 19, 2018; 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.