Imperial Valley Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

IMPERIAL VALLEY PHARMACY LLC

Practice address

1487 Ocotillo Dr
El Centro, CA 92243-4212

Phone

(760) 970-5800

NPI assigned

Feb 27, 2025

Organization subpart

No

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

Authorized official

Name

Prashant Koyani

Title

Owner

Phone

(760) 970-5800

Specialties & licenses 1

Addresses

Other names 1

• IMPERIAL VALLEY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Imperial Valley Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Imperial Valley Pharmacy LLC

  • Long Term Care Pharmacy
  • El Centro, CA
  • NPI 1013715226
  NPD tax ID

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1336946136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1487 OCOTILLO DR",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1487 OCOTILLO DR",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434212",
            "telephone_number": "760-970-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL VALLEY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "KOYANI",
        "authorized_official_first_name": "PRASHANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-970-5800"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMPERIAL VALLEY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Imperial Valley Optometric Corporation
• Imperial Valley Optometric Corporation
• Imperial Valley Optometric Corporation
• Imperial Valley Pain & Wellness Management Inc.
• Imperial Valley Pharmacy LLC
• Imperial Valley Podiatry Associates Inc
• Imperial Valley Womens Clinic
• Imperial Valley Womens Clinic
• Imperial Vascular and Wound Care Specialists
• Rose Mary Inman

• Community/Retail Pharmacy in El Centro, CA
• Providers in El Centro, 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 Feb 27, 2025; 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.