Organization Active NPI

PKB Corporation

  • Community/Retail Pharmacy
  • Anaheim, CA
National Provider Identifier
1083945240
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
50145 Issued in CA
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

Updated by the provider on Feb 27, 2025

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Pharmacy2 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.

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.

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.

Verify at the official NPI Registry.