NPIMap

Organization Active NPI

A Family Pharmacy-Hesperia

  • Community/Retail Pharmacy
  • Hesperia, CA
National Provider Identifier
1356430045
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY46638 Issued in CA
Legal business name
A FAMILY PHARMACY-HESPERIA
Practice address
11919 Hesperia Rd
Ste C
Hesperia, CA 92345-1855
Phone
(760) 244-3777
Fax
(760) 242-8617
NPI assigned
Oct 12, 2006
Last updated
Apr 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Thomas Tekele, PHARMACIST
Title
President
Phone
(760) 242-5452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY46638 CA Primary

Addresses

Primary practice location

11919 Hesperia Rd
Ste C
Hesperia, CA 92345-1855

Mailing address

PO Box 900
Victorville, CA 92393-0900

Other identifiers 2

IdentifierTypeStateIssuer
5614020OtherOTHER ID NUMBER
5614020OtherOTHER ID NUMBER-COMMERCIAL NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1356430045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923930900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 HESPERIA RD",
            "address_2": "STE C",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451855",
            "telephone_number": "760-244-3777",
            "fax_number": "760-242-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FAMILY PHARMACY-HESPERIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "TEKELE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-242-5452",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5614020",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5614020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.