Memory Island Pharmacy PC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MEMORY ISLAND PHARMACY PC

Doing business as

Primero Pharmacy

Practice address

29800 Bradley Rd Ste 112
Menifee, CA 92586-6524

Phone

(951) 672-4465

NPI assigned

Jun 24, 2024

Last updated

Dec 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin Singh

Title

Pic

Phone

(951) 672-4465

Specialties & licenses 1

Addresses

Other names 1

• PRIMERO PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734825600000",
    "number": "1417791302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29800 BRADLEY RD STE 112",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925866524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29800 BRADLEY RD STE 112",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925866524",
            "telephone_number": "951-672-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORY ISLAND PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-12-22",
        "certification_date": "2024-12-22",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "951-672-4465"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMERO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRIMERO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Menifee, CA
• Providers in Menifee, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.