NPIMap

Organization Active NPI

Vista Pharmacies, Inc

  • Community/Retail Pharmacy
  • Montclair, CA
National Provider Identifier
1306940358
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY44318 Issued in CA
Legal business name
VISTA PHARMACIES, INC
Practice address
9625 Monte Vista Ave
Ste 108
Montclair, CA 91763-2234
Phone
(909) 626-4315
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Authorized official

Name
San Le, PHARMD
Title
Pharmacist in Charge
Phone
(909) 626-4315

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY44318 CA Primary

Addresses

Primary practice location

9625 Monte Vista Ave
Ste 108
Montclair, CA 91763-2234

Mailing address

9625 Monte Vista Ave
Ste 108
Montclair, CA 91763-2234
Phone (909) 626-4315

Other identifiers 2

IdentifierTypeStateIssuer
1989177OtherPK
PHA443180MedicaidCA

Other names 1

  • ALTA VISTA PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vista Pharmacies Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1306940358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 MONTE VISTA AVE",
            "address_2": "STE 108",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632234",
            "telephone_number": "909-626-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 MONTE VISTA AVE",
            "address_2": "STE 108",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632234",
            "telephone_number": "909-626-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA PHARMACIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "SAN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "909-626-4315",
        "authorized_official_credential": "PHARMD"
    },
    "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": "PHY44318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1989177",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA443180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALTA VISTA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.