NPIMap

Organization Active NPI

Inland Pharmacy Inc

  • Community/Retail Pharmacy
  • Hemet, CA
National Provider Identifier
1306883392
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY18171 Issued in CA
Legal business name
INLAND PHARMACY INC
Doing business as
INLAND PHARMACY
Practice address
1001 E Latham Ave
Ste P
Hemet, CA 92543-4435
Phone
(951) 658-7111
Fax
(951) 658-7113
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Bruno Tching, PHRMD
Title
Ceo
Phone
(951) 658-7111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY18171 CA Primary

Addresses

Primary practice location

1001 E Latham Ave
Ste P
Hemet, CA 92543-4435

Mailing address

1001 E Latham Ave
Ste P
Hemet, CA 92543-4435
Phone (951) 658-7111

Other identifiers 3

IdentifierTypeStateIssuer
2003611OtherPK
PHA181710MedicaidCA
1306883392MedicaidCA

Other names 1

  • INLAND PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20100930076416 CA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 3971620717 Practice locations: Hemet, CA
O20151020000182 CA Part B Supplier - Mass Immunization (Roster Biller Only) 3971620717 Practice locations: Hemet, CA
O20190805002411 CA Part B Supplier - Pharmacy 3971620717 Practice locations: Hemet, CA
O20200616001760 CA Part B Supplier - Independent Clinical Laboratory 3971620717 Practice locations: Hemet, CA

National Provider Directory

National Provider Directory
Tax ID family
Inland Pharmacy Inc3 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.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1306883392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E LATHAM AVE",
            "address_2": "STE P",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434435",
            "telephone_number": "951-658-7111",
            "fax_number": "951-658-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E LATHAM AVE",
            "address_2": "STE P",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434435",
            "telephone_number": "951-658-7111",
            "fax_number": "951-658-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "TCHING",
        "authorized_official_first_name": "BRUNO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-658-7111",
        "authorized_official_credential": "PHRMD"
    },
    "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": "PHY18171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2003611",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA181710",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306883392",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INLAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "INLAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.