Active NPI
PKB Corporation
- Community/Retail Pharmacy
- Anaheim, CA
National Provider Identifier
1083945240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 50145
- Legal business name
- PKB CORPORATION
- Practice address
- 2519 W Woodland Dr
Anaheim, CA 92801-2637 - Phone
- (949) 581-9840
- Fax
- (949) 770-7545
- NPI assigned
- Jan 27, 2010
- 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
- Benjamin Pham
- Title
- Owner
- Phone
- (949) 581-9840
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 50145 | CA | Primary |
Addresses
Primary practice location
2519 W Woodland Dr
Anaheim, CA 92801-2637
Mailing address
2519 W Woodland Dr
Anaheim, CA 92801-2637
Phone (949) 581-9840
Other names 1
- North Star Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210219000586 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8921287384 | Practice locations: Laguna Hills, CA |
| O20250402000974 | CA | Part B Supplier - Pharmacy | 9537682380 | Practice locations: Anaheim, CA |
National Provider Directory
National Provider Directory- Tax ID family
- North Star Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Anaheim, CA
- NPI 1982419917
Locations
2519 W Woodland Dr
Anaheim, CA 92801
Phone (949) 581-9840
24953 Paseo de Valencia
Ste 17B
Laguna Hills, CA 92653
Phone (949) 581-9840
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Ladera Ranch, CA
- NPI 1801480751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740614400000",
"number": "1083945240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2519 W WOODLAND DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012637",
"telephone_number": "949-581-9840",
"fax_number": "949-770-7545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2519 W WOODLAND DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012637",
"telephone_number": "949-581-9840",
"fax_number": "949-770-7545"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PKB CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2010-01-27",
"last_updated": "2025-02-27",
"certification_date": "2025-02-27",
"status": "A",
"authorized_official_last_name": "PHAM",
"authorized_official_first_name": "BENJAMIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "949-581-9840"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "50145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "North Star Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.