Innova Pharmacy II

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

INNOVA PHARMACY II

Practice address

3701 J St Ste 101
Sacramento, CA 95816-5542

Phone

(916) 465-8999

Fax

(916) 475-1285

NPI assigned

Apr 11, 2020

Organization subpart

No

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

Authorized official

Name

Tim Thien Le, PHARM.D.

Title

President/Ceo

Phone

(916) 220-3344

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA3 enrollments

Enrollment records 3

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

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

{
    "created_epoch": "1586563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1124647011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "916-220-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "916-465-8999",
            "fax_number": "916-475-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA PHARMACY II",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-11",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "THIEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "916-220-3344",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Inner Symmetry Nursing Corporation
• Paul Innerarity, M.A., LMFT
• Innova Pharmacy III
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• Innovage California Pace-Sacramento, LLC
• Innovative DME LLC
• Isao K. Inouye, MD

• Community/Retail Pharmacy in Sacramento, CA
• Providers in Sacramento, 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 Oct 22, 2021; 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.