Organization Active NPI

Vip Pharmacy Inc

Doing business as VIP Pharmacy

  • Community/Retail Pharmacy
  • Redlands, CA
National Provider Identifier
1225728991
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
59008OtherCACA BOARD OF PHARMACY

Other names 1

  • VIP Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

National Provider Directory

National Provider Directory
Tax ID family
Vip Pharmacy Inc3 organizations share this tax ID, including this one

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.

Verify at the official NPI Registry.