Organization Active NPI

Dmmjr Inc

Doing business as DMK Pharmacy

  • Community/Retail Pharmacy
  • Alpine, CA
National Provider Identifier
1134528425
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
51950 Issued in CA
Legal business name
DMMJR INC
Doing business as
DMK Pharmacy
Practice address
1730 Alpine Blvd Ste 109
Alpine, CA 91901-3877
Phone
(619) 722-6442
Fax
(619) 722-6443
NPI assigned
Aug 22, 2014
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Kristina R Johnson
Title
President/Manager
Phone
(619) 722-6442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 51950 CA Primary

Addresses

Primary practice location

1730 Alpine Blvd Ste 109
Alpine, CA 91901-3877

Mailing address

1730 Alpine Blvd Ste 109
Alpine, CA 91901-3877
Phone (619) 722-6442

Other identifiers 1

IdentifierTypeStateIssuer
2147857OtherPK

Other names 1

  • DMK Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150813010506 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7315252772 Practice locations: Alpine, CA

National Provider Directory

National Provider Directory
Tax ID family
DMK Pharmacy2 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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1134528425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 ALPINE BLVD STE 109",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919013877",
            "telephone_number": "619-722-6442",
            "fax_number": "619-722-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 ALPINE BLVD STE 109",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919013877",
            "telephone_number": "619-722-6442",
            "fax_number": "619-722-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMMJR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/MANAGER",
        "authorized_official_telephone_number": "619-722-6442"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "51950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147857",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMK Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DMK Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alpine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.