Fox Hills Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY46748 Issued in CA

Legal business name

FOX HILLS PHARMACY INC

Doing business as

Grand Avenue Pharmacies

Practice address

4455 W 117TH St
Ste 101
Hawthorne, CA 90250-2241

Phone

(310) 649-3774

Fax

(310) 649-3720

NPI assigned

Aug 3, 2005

Last updated

Mar 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Margo Sobol, PHARM DNPI 1417382763

Title

Owner

Phone

(310) 649-3775

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• GRAND AVENUE PHARMACIES Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Fox Hills Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fox Hills Pharmacy Inc

  dba Multicare Pharmacy

  • Community/Retail Pharmacy
  • Inglewood, CA
  • NPI 1780836882
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Margo Sobol, PHARMD

  • Pharmacist
  • Sherman Oaks, CA
  • NPI 1417382763
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1235130832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 W 117TH ST",
            "address_2": "STE 101",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502241",
            "telephone_number": "310-649-3774",
            "fax_number": "310-649-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 W 117TH ST",
            "address_2": "STE 101",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502241",
            "telephone_number": "310-649-3774",
            "fax_number": "310-649-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX HILLS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "SOBOL",
        "authorized_official_first_name": "MARGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-649-3775",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46748",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA467480",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001007",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAND AVENUE PHARMACIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Jermaine Floyd Sr.
• Jacqueline Folgar
• Samantha Folkman, PA-C
• Fonthill Gardens Inc
• For Eyes Optical of California, Inc
• Fratt Dental Corporation (Castle Dental Centers-Hawthorne)
• Miki Sadie Fukusumi
• Albert Fuller III
• James Gabelich, PHARMD
• Gabes Medical Supply

• Community/Retail Pharmacy in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.