Individual provider Active NPI

Amy Thu Le

  • Pharmacist
  • Redlands, CA
National Provider Identifier
1396401303
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
85503 Issued in CA
Practice address
1600 E Citrus Ave Ste K
Redlands, CA 92374-4218
Phone
(909) 726-3080
NPI assigned
Nov 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 85503 CA Primary

Addresses

Primary practice location

1600 E Citrus Ave Ste K
Redlands, CA 92374-4218

Mailing address

1600 E Citrus Ave Ste K
Redlands, CA 92374-4218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
85503CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Security Pharmacy, Inc Current Accepting new patients
Jsor Pharmacy Inc Current Accepting new patients
Garfield Beach CVS LLC PastSince Nov 1, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1396401303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E CITRUS AVE STE K",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E CITRUS AVE STE K",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744218",
            "telephone_number": "909-726-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "AMY THU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.