Active NPI
Vip Pharmacy Inc
Doing business as VIP Pharmacy
- Community/Retail Pharmacy
- Redlands, CA
National Provider Identifier
1225728991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- VIP PHARMACY INC
- Doing business as
- VIP Pharmacy
- Practice address
- 1600 E Citrus Ave Ste K
Redlands, CA 92374-4218 - Phone
- (909) 726-3080
- Fax
- (909) 705-4951
- NPI assigned
- May 8, 2023
- Last updated
- May 8, 2023
- 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
- Alyssa Tamura, PHARMD
- Title
- Pharmacist
- Phone
- (909) 573-0123
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
1600 E Citrus Ave Ste K
Redlands, CA 92374-4218
Mailing address
1600 E Citrus Ave Ste K
Redlands, CA 92374-4218
Phone (909) 726-3080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59008 | Other | CA | CA BOARD OF PHARMACY |
Other names 1
- VIP Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201130001276 | CA | Part B Supplier - Pharmacy | 7911318779 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chino, CA; Perris, CA; Redlands, CA |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba VIP Pharmacy
- Community/Retail Pharmacy
- Perris, CA
- NPI 1225400518
O20201130001276
-
dba Vip Pharmacy
- Community/Retail Pharmacy
- Chino, CA
- NPI 1891838272
O20201130001276
National Provider Directory
National Provider Directory- Tax ID family
- Vip Pharmacy Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
13193 Central Ave
Ste 120
Chino, CA 91710
Phone (909) 573-0123
1600 E Citrus Ave
Ste K
Redlands, CA 92374
Phone (909) 726-3080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683504000000",
"number": "1225728991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 E CITRUS AVE STE K",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923744218",
"telephone_number": "909-726-3080",
"fax_number": "909-705-4951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 E CITRUS AVE STE K",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923744218",
"telephone_number": "909-726-3080",
"fax_number": "909-705-4951"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIP PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-08",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"status": "A",
"authorized_official_last_name": "TAMURA",
"authorized_official_first_name": "ALYSSA",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "909-573-0123",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA BOARD OF PHARMACY",
"identifier": "59008",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "VIP Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.