Organization Active NPI

FWD Healthcare Inc

  • Community/Retail Pharmacy
  • San Gabriel, CA
National Provider Identifier
1114093879
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FWD HEALTHCARE INC
Practice address
1635 S San Gabriel Blvd
Unit a
San Gabriel, CA 91776-3973
Phone
(626) 280-3060
Fax
(626) 280-1215
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Khanh-Long Thai, PHARM D
Title
Ceo
Phone
(626) 674-6718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1635 S San Gabriel Blvd
Unit a
San Gabriel, CA 91776-3973

Mailing address

1635 S San Gabriel Blvd
Unit a
San Gabriel, CA 91776-3973
Phone (626) 280-3060

Other identifiers 2

IdentifierTypeStateIssuer
2050095OtherPK
PHA437040MedicaidCA

Other names 1

  • 986 Pharmacy #8037 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20251230002490 CA Part B Supplier - Mass Immunization (Roster Biller Only) 0143716027 Practice locations: San Gabriel, CA
O20260313002586 CA DME Supplier - Pharmacy 0143716027 Practice locations: San Gabriel, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2332179FWD Healthcare Inc Dba 986 Pharmarcy #80371635 S San Gabriel Blvd Suite a, San Gabriel, CA 91776Certificate of waiverOct 14, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
986 Pharmacy #80371635 S San Gabriel Blvd, San Gabriel, CA 91776-3973(626) 280-3060 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs Accepts assignmentParticipating since Dec 17, 2025

National Provider Directory

National Provider Directory

Locations

1730 S San Gabriel Blvd
#A
San Gabriel, CA 91776
Phone (626) 573-4698

1635 S San Gabriel Blvd
Ste A
San Gabriel, CA 91776
Phone (626) 280-3060

Practitioners & affiliated clinicians

Practitioners 2

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": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1114093879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 S SAN GABRIEL BLVD",
            "address_2": "UNIT A",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763973",
            "telephone_number": "626-280-3060",
            "fax_number": "626-280-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 S SAN GABRIEL BLVD",
            "address_2": "UNIT A",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763973",
            "telephone_number": "626-280-3060",
            "fax_number": "626-280-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FWD HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-08-15",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "THAI",
        "authorized_official_first_name": "KHANH-LONG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-674-6718",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2050095",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA437040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "986 Pharmacy #8037",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.