986 Pharmacy 8001 Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

986 PHARMACY 8001 INC

Practice address

2143 Foothill Blvd
La Verne, CA 91750-2942

Phone

(909) 596-6168

Fax

(909) 596-6155

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Lilia Xu, PHARMD

Title

Ceo

Phone

(909) 596-6168

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• 986 Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elijah Elias Bernal, RPH

  • Pharmacist
  • La Verne, CA
  • NPI 1861203820
  NPD (past)
• Janine N Chen, RPH

  • Pharmacist
  • La Verne, CA
  • NPI 1124687587
  NPD (past)
• Vicky Lei Jing

  • Pharmacist
  • La Verne, CA
  • NPI 1811528433
  NPD (past)
• Lillian Nguyen, PHARMD

  • Pharmacist
  • La Verne, CA
  • NPI 1366275729
  NPD (past)
• Tyler Tran, PHARMD

  • Pharmacist
  • La Verne, CA
  • NPI 1063381796
  NPD (past)
• Chelsea Nicole White, PHARMD

  • Pharmacist
  • Yorba Linda, CA
  • NPI 1114637451
  NPD (past)
• Chia Hsin Wu, PHARM.D.

  • Pharmacist
  • San Diego, CA
  • NPI 1841066214
  NPD (past)

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1245604792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502942",
            "telephone_number": "909-596-6168",
            "fax_number": "909-596-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502942",
            "telephone_number": "909-596-6168",
            "fax_number": "909-596-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "986 PHARMACY 8001 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "LILIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-596-6168",
        "authorized_official_credential": "PHARMD"
    },
    "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": "PHY53763",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155502",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "986 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 986 Pharmacy 8001 Inc
• Amal Abdelmaek
• Phillip David Acevedo Jr., D.D.S.
• Latha Madhavi Achanta, MD MPH
• Joanna Acosta, LVN
• Jessica Adams, MOT, OTR/L

• All providers in La Verne, CA
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.