NPIMap

Organization Active NPI

Botrosons Pharmaceutical Inc

Doing business as Larson's Pharmacy

  • Community/Retail Pharmacy
  • Colton, CA
National Provider Identifier
1396834073
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY47035 Issued in CA
Legal business name
BOTROSONS PHARMACEUTICAL INC
Doing business as
Larson's Pharmacy
Practice address
142 W H St
Colton, CA 92324-2923
Phone
(909) 825-1950
Fax
(909) 825-9330
NPI assigned
Oct 12, 2006
Last updated
Feb 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Ed Botros, BACHELOR DEGREE
Title
Pic
Phone
(909) 825-1950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY47035 CA Primary

Addresses

Primary practice location

142 W H St
Colton, CA 92324-2923

Mailing address

142 W H St
Colton, CA 92324-2923
Phone (909) 825-1950

Other names 1

  • LARSON'S PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930071230 CA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 7719196013 Practice locations: Colton, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Larson's Pharmacy142 West H St, Colton, CA 92324-2923(909) 825-1950 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf Does not accept assignmentParticipating since Jun 9, 2004

National Provider Directory

National Provider Directory
Tax ID family
Botrosons Pharmaceutical Inc2 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.

Locations

142 W H St
Colton, CA 92324
Phone (909) 825-1950

Practitioners & affiliated clinicians

Practitioners 3

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1396834073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 W H ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242923",
            "telephone_number": "909-825-1950",
            "fax_number": "909-825-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 W H ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242923",
            "telephone_number": "909-825-1950",
            "fax_number": "909-825-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTROSONS PHARMACEUTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "BOTROS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "909-825-1950",
        "authorized_official_credential": "BACHELOR DEGREE"
    },
    "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": "PHY47035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LARSON'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.