Western Pharmacy Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55908 Issued in CA

Legal business name

WESTERN PHARMACY GROUP LLC

Practice address

4074 Fairmount Ave
San Diego, CA 92105-1608

Phone

(619) 284-1141

Fax

(619) 284-0503

NPI assigned

Jun 6, 2008

Organization subpart

No

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

Authorized official

Name

Kevin Faris

Title

Ceo

Phone

(360) 220-4818

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDICAL CENTER PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1306005079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 COHO WAY STE 312",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252066",
            "telephone_number": "360-685-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4074 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "619-284-1141",
            "fax_number": "619-284-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PHARMACY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "FARIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-220-4818"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Specialty Group L.P.
• John Robert Western, PA

• Community/Retail Pharmacy in San Diego, CA
• Providers in San Diego, 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 Jul 19, 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.