NPIMap

Organization Active NPI

Imgrx SJ Valley, Inc.

Doing business as United Health Centers Pharmacy Earlimart

  • Community/Retail Pharmacy
  • Earlimart, CA
National Provider Identifier
1316294598
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY 54521 Issued in CA
Legal business name
IMGRX SJ VALLEY, INC.
Doing business as
United Health Centers Pharmacy Earlimart
Practice address
476 E Washington Ave
Earlimart, CA 93219
Phone
(661) 849-2781
Fax
(616) 849-4005
NPI assigned
Aug 7, 2012
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
IMGRX SJ VALLEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Michael Brown
Title
Vice President, Managed Services
Phone
(281) 749-4764

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY 54521 CA Primary

Addresses

Primary practice location

476 E Washington Ave
Earlimart, CA 93219

Mailing address

Attn: CHC Retail Pharmacy Dept. 13651 Dublin CT
Stafford, TX 77477
Phone (281) 749-4000

Other names 1

  • United Health Centers Pharmacy Earlimart Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imgrx SJ Valley Inc11 organizations share this tax ID, including this one
Part of
Imgrx SJ Valley Inc

Other organizations with this tax ID 10

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

Locations

1330 Enclave Pkwy
Ste 900
Houston, TX 77077

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1316294598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: CHC RETAIL PHARMACY DEPT. 13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "281-749-4000",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 E WASHINGTON AVE",
            "city": "EARLIMART",
            "state": "CA",
            "postal_code": "93219",
            "telephone_number": "661-849-2781",
            "fax_number": "616-849-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMGRX SJ VALLEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMGRX SJ VALLEY, INC.",
        "enumeration_date": "2012-08-07",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED SERVICES",
        "authorized_official_telephone_number": "281-749-4764"
    },
    "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": "PHY 54521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Health Centers Pharmacy Earlimart",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "United Health Centers Pharmacy Earlimart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Earlimart, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.