NPIMap

Organization Active NPI

Peachland Pharmacy, Inc.

Doing business as Valencia Pharmacy

  • Community/Retail Pharmacy
  • Newhall, CA
National Provider Identifier
1073938114
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PEACHLAND PHARMACY, INC.
Doing business as
Valencia Pharmacy
Practice address
25050 Peachland Ave Ste 100
Newhall, CA 91321-2523
Phone
(661) 255-7910
Fax
(661) 255-7987
NPI assigned
Feb 26, 2014
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Aram K Penaranda
Title
Cfo/Owner
Phone
(619) 962-2043

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

25050 Peachland Ave Ste 100
Newhall, CA 91321-2523

Mailing address

8881 Fletcher Pkwy Ste 103
La Mesa, CA 91942-3130
Phone (858) 560-1979

Other names 1

  • Valencia Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120927000485 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7113123639 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newhall, CA; Newport Beach, CA; Orange, CA

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Pacific Pharmacy Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1073938114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PKWY STE 103",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423130",
            "telephone_number": "858-560-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25050 PEACHLAND AVE STE 100",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212523",
            "telephone_number": "661-255-7910",
            "fax_number": "661-255-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHLAND PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-26",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "PENARANDA",
        "authorized_official_first_name": "ARAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO/OWNER",
        "authorized_official_telephone_number": "619-962-2043"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valencia Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valencia Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newhall, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.