Primecare Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY44391 Issued in CA

Legal business name

PRIMECARE PHARMACY INC

Doing business as

Martin Pharmacy

Practice address

801 S. Vermont Ave
Ste 104
Los Angeles, CA 90005-1567

Phone

(213) 382-9718

Fax

(213) 380-6792

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Julie KimNPI 1720452220

Title

Ceo

Phone

(213) 382-9718

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Martin Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie Kim

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Los Angeles, CA
  • NPI 1720452220
  NPD Authorized official
• Seunghee Choi

  • Pharmacist
  • Los Angeles, CA
  • NPI 1487003158
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1316059231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S. VERMONT AVE",
            "address_2": "STE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051567",
            "telephone_number": "213-382-9718",
            "fax_number": "213-380-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S. VERMONT AVE",
            "address_2": "STE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051567",
            "telephone_number": "213-382-9718",
            "fax_number": "213-380-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-382-9718"
    },
    "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": "PHY44391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA443910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1997466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martin Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prime Star Home Care, LLC
• Prime Star Home Health, Inc.
• Prime Transit
• Prime Wellness Community Health Center
• Kathryn Primeau, MSW, ASW
• Marlowe J Primero
• Primescan Medical Diagnostic, Inc.
• Channelle Belmonte Primitivo
• Primus Home Health Care, Inc
• Alyson Prince, APRN

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, 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 Mar 5, 2021; 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.