Active NPI
Socal Pharmacy Inc
- Community/Retail Pharmacy
- Garden Grove, CA
National Provider Identifier
1295210722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SOCAL PHARMACY INC
- Doing business as
- GROVE HARBOR MEDICAL CENTER PHARMACY
- Practice address
- 12555 Garden Grove Blvd Ste 102
Garden Grove, CA 92843-1903 - Phone
- (714) 636-0593
- Fax
- (714) 636-7708
- NPI assigned
- Oct 1, 2018
- Organization subpart
- Yes
- Parent organization
- SOCAL PHARMACY INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Judy Coleman, MRS
- Title
- Billing Manager
- Phone
- (714) 636-0593
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
12555 Garden Grove Blvd Ste 102
Garden Grove, CA 92843-1903
Mailing address
12555 Garden Grove Blvd Ste 102
Garden Grove, CA 92843-1903
Phone (714) 636-0593
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649713777 | Medicaid | CA |
Other names 1
- GROVE HARBOR MEDICAL CENTER PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Socal Pharmacy LLC
- Part of
- Socal Pharmacy LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Garden Grove, CA
- NPI 1033744230
-
- Long Term Care Pharmacy
- Garden Grove, CA
- NPI 1447183975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1538352000000",
"number": "1295210722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12555 GARDEN GROVE BLVD STE 102",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431903",
"telephone_number": "714-636-0593",
"fax_number": "714-636-7708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12555 GARDEN GROVE BLVD STE 102",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431903",
"telephone_number": "714-636-0593",
"fax_number": "714-636-7708"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOCAL PHARMACY INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOCAL PHARMACY INC.",
"enumeration_date": "2018-10-01",
"last_updated": "2018-10-01",
"status": "A",
"authorized_official_last_name": "COLEMAN",
"authorized_official_first_name": "JUDY",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "714-636-0593",
"authorized_official_credential": "MRS"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1649713777",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "GROVE HARBOR MEDICAL CENTER PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.