Organization Active NPI

Saleh Pharmacy, Inc.

  • Pharmacy
  • Santa Ana, CA
National Provider Identifier
1114948163
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SALEH PHARMACY, INC.
Doing business as
Wagner Pharmacy
Practice address
1224 East McFadden Ave.
Santa Ana, CA 92705
Phone
(714) 547-3590
Fax
(714) 547-5977
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Mohamed SalehNPI 1417469735
Title
Ceo/Cfo/Sec./Dir.
Phone
(510) 924-6688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X PHY35724 CA

Addresses

Primary practice location

1224 East McFadden Ave.
Santa Ana, CA 92705

Mailing address

1224 East McFadden Ave.
Santa Ana, CA 92705
Phone (714) 547-3590

Other identifiers 4

IdentifierTypeStateIssuer
PHY35724OtherCASTATE LICENSE
954218320OtherCAFEDERAL TAX ID #
0597596OtherCANABP # OR NCPDP #
PHA357240MedicaidCA

Other names 1

  • Wagner Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230407001308 CA Part B Supplier - Pharmacy 9032584883 1 other NPI on this enrollment
Practice locations: Santa Ana, CA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1114948163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 EAST MCFADDEN AVE.",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "714-547-3590",
            "fax_number": "714-547-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 EAST MCFADDEN AVE.",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "714-547-3590",
            "fax_number": "714-547-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEH PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO/CFO/SEC./DIR.",
        "authorized_official_telephone_number": "510-924-6688"
    },
    "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": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY35724",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PHY35724",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID #",
            "identifier": "954218320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP # OR NCPDP #",
            "identifier": "0597596",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA357240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagner Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wagner Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.