NPIMap

Organization Active NPI

Ruhs-Corona Pharmacy

  • Community/Retail Pharmacy
  • Corona, CA
National Provider Identifier
1235622945
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
56092 Issued in CA
Legal business name
RUHS-CORONA PHARMACY
Doing business as
Ruhs-Corona Pharmacy
Practice address
2813 S Main St
Corona, CA 92882-5942
Phone
(951) 955-0111
Fax
(951) 486-4540
NPI assigned
Jun 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Authorized official

Name
Davalyn Tidwell
Title
Assistant Director of Pharmacy
Phone
(951) 486-4527

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 56092 CA Primary
Mail Order Pharmacy 3336M0002X

Addresses

Primary practice location

2813 S Main St
Corona, CA 92882-5942

Mailing address

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4761

Other identifiers 1

IdentifierTypeStateIssuer
2177826OtherPK

Other names 1

  • RUHS-CORONA PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Riverside County244 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1235622945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825942",
            "telephone_number": "951-955-0111",
            "fax_number": "951-486-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUHS-CORONA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "DAVALYN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "951-486-4527"
    },
    "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": "56092",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177826",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RUHS-CORONA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.