Tustin Community Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY46551 Issued in CA

Legal business name

TUSTIN COMMUNITY PHARMACY INC

Doing business as

Villa Park Pharmacy

Practice address

17821 Santiago Blvd
Villa Park, CA 92861-4133

Phone

(714) 998-3030

Fax

(714) 998-6060

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Adam Bollenbach, PHARM.D.NPI 1598111783

Title

Pharmacist-in-Charge, Vice Pres.

Phone

(714) 998-3030

Specialties & licenses 1

Addresses

Other names 1

• Villa Park Pharmacy Doing business as

Practitioners 2

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.

• Adam Bollenbach, PHARMD

  • Pharmacist
  • Villa Park, CA
  • NPI 1598111783
  Authorized official Same address or phone
• Jerry Don Oswald, PHARMD

  • Pharmacist
  • Tustin, CA
  • NPI 1003574963
  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497891766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17821 SANTIAGO BLVD",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614133",
            "telephone_number": "714-998-3030",
            "fax_number": "714-998-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17821 SANTIAGO BLVD",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614133",
            "telephone_number": "714-998-3030",
            "fax_number": "714-998-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSTIN COMMUNITY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLLENBACH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE, VICE PRES.",
        "authorized_official_telephone_number": "714-998-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rajesh Sharma, MSW, BCBA
• Sparkles KC LLC (Path To Serenity)
• Rajagopal Keerthy Sunder, M.D.
• Sunrise Holistic Care Inc (Sunrise Holistic)
• Victoria Barrett Taylor, M.A., BCBA
• VPRP, Inc. (Villa Park Pharmacy)
• VPRP, Inc. (Villa Park Pharmacy)
• Linda M. Warner, D.O.
• William N. Langstaff, D.M.D.
• Wendy Young

• Community/Retail Pharmacy in Villa Park, CA
• Providers in Villa Park, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.