Active NPI
Porterville Pharmacy Inc
- Community/Retail Pharmacy
- Porterville, CA
National Provider Identifier
1184083644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY53909
- Legal business name
- PORTERVILLE PHARMACY INC
- Practice address
- 406 W Putnam Ave
Porterville, CA 93257-3321 - Phone
- (559) 793-4410
- NPI assigned
- Feb 12, 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
- John Mikhael
- Title
- Owner / Pic
- Phone
- (559) 793-4410
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY53909 | CA | Primary |
Addresses
Primary practice location
406 W Putnam Ave
Porterville, CA 93257-3321
Mailing address
406 W Putnam Ave
Porterville, CA 93257-3321
Phone (559) 306-0404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2158309 | Other | PK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160719002498 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 6103119797 |
1 other NPI on this enrollment Practice locations: Porterville, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Porterville Pharmacy Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Porterville, CA
- NPI 1427939891
-
- Long Term Care Pharmacy
- Porterville, CA
- NPI 1528949997
Locations
406 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-4702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455235200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1554768000000",
"number": "1184083644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 W PUTNAM AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "932573321",
"telephone_number": "559-306-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 W PUTNAM AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "932573321",
"telephone_number": "559-793-4410"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTERVILLE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-12",
"last_updated": "2019-04-09",
"status": "A",
"authorized_official_last_name": "MIKHAEL",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "OWNER / PIC",
"authorized_official_telephone_number": "559-793-4410"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY53909",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2158309",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Porterville, CA
- Porterville Convalescent, Inc.
- Porterville Express Specialty Pharmacy, LLC
- Porterville Express Specialty Pharmacy, LLC
- Porterville Halfway House
- Porterville Oncology Associates, Inc.
- Porterville Pharmacy Inc
- Porterville Pharmacy Inc
- Porterville Pharmacy Inc
- Porterville Physical Therapy Sports & Orthopedics
- Porterville Sheltered Workshop, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.