Active NPI
Nimble Pharmacy Inc
Doing business as Nimble Pharmacy
- Community/Retail Pharmacy
- National City, CA
National Provider Identifier
1174994560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY53907
- Legal business name
- NIMBLE PHARMACY INC
- Doing business as
- Nimble Pharmacy
- Practice address
- 801 National City Blvd Ste B
National City, CA 91950-3200 - Phone
- (866) 966-4625
- Fax
- (650) 889-4199
- NPI assigned
- Oct 12, 2015
- Last updated
- Dec 18, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Talha Waqar
- Title
- Owner
- Phone
- (866) 966-4625
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | PHY53907 | CA | Primary |
Addresses
Primary practice location
801 National City Blvd Ste B
National City, CA 91950-3200
Mailing address
1134 Crane St
Menlo Park, CA 94025-4359
Phone (866) 966-4625
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174994560 | Medicaid | CA | |
| 2154597 | Other | PK |
Other names 1
- Nimble Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Nimble Pharmacy Inc
Other organizations with this tax ID 9
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Palo Alto, CA
- NPI 1679944821
-
dba Nimble Pharmacy
- Community/Retail Pharmacy
- Farmers Branch, TX
- NPI 1255827986
Locations
1134 Crane St
Menlo Park, CA 94025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1482019200000",
"number": "1174994560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1134 CRANE ST",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254359",
"telephone_number": "866-966-4625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 NATIONAL CITY BLVD STE B",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919503200",
"telephone_number": "866-966-4625",
"fax_number": "650-889-4199"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NIMBLE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-12",
"last_updated": "2016-12-18",
"status": "A",
"authorized_official_last_name": "WAQAR",
"authorized_official_first_name": "TALHA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "866-966-4625"
},
"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": "PHY53907",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174994560",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2154597",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Nimble Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in National City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.