Organization Active NPI

United Pharmacy

  • Pharmacy
  • Dinuba, CA
National Provider Identifier
1255334702
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY40825 Issued in CA
Legal business name
UNITED PHARMACY
Practice address
1625 E El Monte Way
Dinuba, CA 93618-1832
Phone
(559) 591-6400
Fax
(559) 591-8439
NPI assigned
May 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Edward J Derderian, PHARM.D.; R.PH.
Title
Owner/Pharmacist
Phone
(559) 591-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY40825 CA Primary

Addresses

Primary practice location

1625 E El Monte Way
Dinuba, CA 93618-1832

Mailing address

1625 E El Monte Way
Dinuba, CA 93618-1832
Phone (559) 591-6400

Other identifiers 1

IdentifierTypeStateIssuer
PHA408250MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
United Pharmacy2 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.

Locations

1625 E El Monte Way
Dinuba, CA 93618
Phone (559) 591-6400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255334702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E EL MONTE WAY",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936181832",
            "telephone_number": "559-591-6400",
            "fax_number": "559-591-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E EL MONTE WAY",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936181832",
            "telephone_number": "559-591-6400",
            "fax_number": "559-591-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DERDERIAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "559-591-6400",
        "authorized_official_credential": "PHARM.D.; R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY40825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA408250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dinuba, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.