NPIMap

Organization Active NPI

Linda RX Pharmacy Inc

  • Community/Retail Pharmacy
  • San Jose, CA
National Provider Identifier
1124228549
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY48645 Issued in CA
Legal business name
LINDA RX PHARMACY INC
Practice address
1569 Lexann Ave
130
San Jose, CA 95121-1794
Phone
(408) 270-2828
Fax
(408) 270-2092
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Authorized official

Name
Linda Phuong, PHRMDNPI 1023108024
Title
Owner
Phone
(408) 270-2828

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY48645 CA Primary

Addresses

Primary practice location

1569 Lexann Ave
130
San Jose, CA 95121-1794

Mailing address

1569 Lexann Ave
130
San Jose, CA 95121-1794
Phone (408) 270-2828

Other identifiers 2

IdentifierTypeStateIssuer
5628372OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHA486450MedicaidCA

Other names 1

  • LINDA RX PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160204000871 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1254631021 Practice locations: San Jose, CA

National Provider Directory

National Provider Directory
Tax ID family
Linda Phuong2 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.

Practitioners & affiliated clinicians

Practitioners 5

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": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1124228549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 LEXANN AVE",
            "address_2": "130",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211794",
            "telephone_number": "408-270-2828",
            "fax_number": "408-270-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 LEXANN AVE",
            "address_2": "130",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211794",
            "telephone_number": "408-270-2828",
            "fax_number": "408-270-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA RX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "PHUONG",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-270-2828",
        "authorized_official_credential": "PHRMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY48645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5628372",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA486450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINDA RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.