NPIMap

Organization Active NPI

Park Medical Pharmacy, Inc

  • Community/Retail Pharmacy
  • Chula Vista, CA
National Provider Identifier
1407153273
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY50576 Issued in CA
Legal business name
PARK MEDICAL PHARMACY, INC
Practice address
450 4TH Ave
Suite 100
Chula Vista, CA 91910-4426
Phone
(619) 420-0540
Fax
(619) 420-7750
NPI assigned
Feb 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
Ms. Susie Pimentel
Title
General Operations Manager
Phone
(619) 238-9501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY50576 CA Primary

Addresses

Primary practice location

450 4TH Ave
Suite 100
Chula Vista, CA 91910-4426

Mailing address

450 4TH Ave
Suite 100
Chula Vista, CA 91910-4426
Phone (619) 420-0540

Other names 1

  • Community Medical Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

450 Fourth Ave
Ste 100
Chula Vista, CA 91910
Phone (619) 420-0540

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1407153273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 4TH AVE",
            "address_2": "SUITE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104426",
            "telephone_number": "619-420-0540",
            "fax_number": "619-420-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 4TH AVE",
            "address_2": "SUITE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104426",
            "telephone_number": "619-420-0540",
            "fax_number": "619-420-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "PIMENTEL",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "GENERAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "619-238-9501",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY50576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.