NPIMap

Organization Active NPI

Mojave Pharmacy Inc

  • Community/Retail Pharmacy
  • Mojave, CA
National Provider Identifier
1477613610
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY47150 Issued in CA
Legal business name
MOJAVE PHARMACY INC
Practice address
16912 Highway 14
Mojave, CA 93501-1226
Phone
(661) 824-1800
Fax
(661) 824-1802
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Authorized official

Name
Tan DONPI 1336159870
Title
Owner
Phone
(661) 824-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY47150 CA Primary

Addresses

Primary practice location

16912 Highway 14
Mojave, CA 93501-1226

Mailing address

16912 Highway 14
Mojave, CA 93501-1226
Phone (661) 824-1800

Other identifiers 2

IdentifierTypeStateIssuer
PHA471500MedicaidCA
2113555OtherPK

Other names 1

  • MOJAVE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

16912 Highway 14
Mojave, CA 93501
Phone (661) 824-1800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1477613610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16912 HIGHWAY 14",
            "city": "MOJAVE",
            "state": "CA",
            "postal_code": "935011226",
            "telephone_number": "661-824-1800",
            "fax_number": "661-824-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16912 HIGHWAY 14",
            "city": "MOJAVE",
            "state": "CA",
            "postal_code": "935011226",
            "telephone_number": "661-824-1800",
            "fax_number": "661-824-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOJAVE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "TAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-824-1800"
    },
    "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": "PHY47150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA471500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2113555",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOJAVE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mojave, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.