Organization Active NPI

KM Healthcare Inc

Doing business as 986 Pharmacy #8023

  • Community/Retail Pharmacy
  • Arcadia, CA
National Provider Identifier
1144064510
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KM HEALTHCARE INC
Doing business as
986 Pharmacy #8023
Practice address
612 W Duarte Rd Ste 102
Arcadia, CA 91007-9221
Phone
(626) 317-5001
Fax
(626) 317-5035
NPI assigned
Jun 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Minh Chau, PHARM.D.
Title
Ceo
Phone
(626) 317-5001

Specialties & licenses 1

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

Addresses

Primary practice location

612 W Duarte Rd Ste 102
Arcadia, CA 91007-9221

Mailing address

612 W Duarte Rd Ste 102
Arcadia, CA 91007-9221
Phone (626) 317-5001

Other identifiers 1

IdentifierTypeStateIssuer
59368OtherCASTATE BOARD OF PHARMACY

Other names 1

  • 986 Pharmacy #8023 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240920002655 CA Part B Supplier - Mass Immunization (Roster Biller Only) 8921549692 Practice locations: Arcadia, CA
O20241101003070 CA DME Supplier - Pharmacy 8921549692 Practice locations: Arcadia, 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2308914KM Healthcare Inc612 W Duarte Rd # 102, Arcadia, CA 91007Certificate of waiverAug 5, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
KM Healthcare Inc.612 W Duarte Rd, Arcadia, CA 91007-9221(626) 317-5001 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs Accepts assignmentParticipating since Aug 12, 2024

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": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1144064510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 102",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079221",
            "telephone_number": "626-317-5001",
            "fax_number": "626-317-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 102",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079221",
            "telephone_number": "626-317-5001",
            "fax_number": "626-317-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KM HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "CHAU",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-317-5001",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY",
            "identifier": "59368",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "986 Pharmacy #8023",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.