Organization Active NPI

Valley Prescription and Compounding Pharmacy

  • Community/Retail Pharmacy
  • Merced, CA
National Provider Identifier
1306077037
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY50005 Issued in CA
Legal business name
VALLEY PRESCRIPTION AND COMPOUNDING PHARMACY
Doing business as
Valley Prescription and Compounding Pharmacy
Practice address
330 E 13TH St
Merced, CA 95341-6212
Phone
(209) 722-5765
Fax
(209) 722-3296
NPI assigned
Jul 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
Jeffrey Hill, PHARM.D.
Title
Ceo-Owner
Phone
(209) 722-5765

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY50005 CA Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

330 E 13TH St
Merced, CA 95341-6212

Mailing address

330 E 13TH St
Merced, CA 95341-6212
Phone (209) 722-5765

Other identifiers 2

IdentifierTypeStateIssuer
PHA50005MedicaidCA
2121363OtherPK

Other names 1

  • Valley Prescription and Compounding Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930018623 CA DME Supplier - Pharmacy 6406056720 Practice locations: Merced, CA
O20120813000431 CA Part B Supplier - Mass Immunization (Roster Biller Only) 6406056720 Practice locations: Merced, CA

National Provider Directory

National Provider Directory
Tax ID family
Valley Prescription and Compounding Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1306077037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E 13TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416212",
            "telephone_number": "209-722-5765",
            "fax_number": "209-722-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E 13TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416212",
            "telephone_number": "209-722-5765",
            "fax_number": "209-722-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PRESCRIPTION AND COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO-OWNER",
        "authorized_official_telephone_number": "209-722-5765",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50005",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA50005",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121363",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Prescription and Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.