Organization Active NPI

LPS Pharmacy Inc.

  • Community/Retail Pharmacy
  • La Puente, CA
National Provider Identifier
1124557434
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LPS PHARMACY INC.
Doing business as
986 Specialty Pharmacy
Practice address
1647 N. Hacienda Blvd.
La Puente, CA 91744-1137
Phone
(626) 850-5318
Fax
(626) 850-5319
NPI assigned
Jun 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Authorized official

Name
Miss Tomy Vuong, PHARM.D.NPI 1235655499
Title
Pic
Phone
(626) 850-5318

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1647 N. Hacienda Blvd.
La Puente, CA 91744-1137

Mailing address

1647 N. Hacienda Blvd.
La Puente, CA 91744-1137
Phone (626) 850-5318

Other names 1

  • 986 Specialty 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
O20210625000559 CA DME Supplier - Pharmacy 4486055696 Practice locations: La Puente, CA
O20210803003407 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4486055696 Practice locations: La Puente, 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
986 Specialty Pharmacy1647 N Hacienda Blvd, La Puente, CA 91744-1137(626) 850-5318 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs Accepts assignmentParticipating since Apr 29, 2021

National Provider Directory

National Provider Directory

Locations

1647 N Hacienda Blvd
La Puente, CA 91744
Phone (626) 850-5318

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": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1124557434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 N. HACIENDA BLVD.",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441137",
            "telephone_number": "626-850-5318",
            "fax_number": "626-850-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 N. HACIENDA BLVD.",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441137",
            "telephone_number": "626-850-5318",
            "fax_number": "626-850-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LPS PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "VUONG",
        "authorized_official_first_name": "TOMY",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "626-850-5318",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PHARM.D."
    },
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "986 Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.