Pacoima RX Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PACOIMA RX PHARMACY INC

Practice address

13630 Van Nuys Blvd Ste 101
Pacoima, CA 91331-3655

Phone

(747) 227-3077

Fax

(747) 227-3078

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Mayer Rafikalimy

Title

President/Ceo

Phone

(747) 227-3077

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PACOIMA RX PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1104546365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13630 VAN NUYS BLVD STE 101",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313655",
            "telephone_number": "747-227-3077",
            "fax_number": "747-227-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13630 VAN NUYS BLVD STE 101",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313655",
            "telephone_number": "747-227-3077",
            "fax_number": "747-227-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACOIMA RX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "RAFIKALIMY",
        "authorized_official_first_name": "MAYER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "747-227-3077"
    },
    "taxonomies": [
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY58755",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACOIMA RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eleanor Isadora Owen
• Thomas Dean Owens Jr.
• P Ramtin DDS Inc
• Pacoima Charter School
• Pacoima Home Health Care Inc
• Pacoima Urgent Care
• Luzviminda Paddit, PTA
• Lucia Paiva Penaloza
• Maribel Palafox, LMFT
• Ana Park, PHARMD, RPH

• Community/Retail Pharmacy in Pacoima, CA
• Providers in Pacoima, 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 Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.