Concourse RX Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY46886 Issued in CA

Legal business name

CONCOURSE RX PHARMACY INC

Practice address

18575 E. Gale Ave.
#158
City of Industry, CA 91748

Phone

(626) 965-5988

Fax

(626) 965-6588

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Tiffany WuNPI 1669752663

Title

Ceo/Cfo/Sec./Dir.

Phone

(626) 965-5988

Specialties & licenses 1

Addresses

Other names 1

• Concourse Rx Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Tiffany Wu

  • Pharmacist
  • Rancho Palos Verdes, CA
  • NPI 1669752663
  NPD Authorized official
• Yihwa Jung Chai, RPH

  • Pharmacist
  • City of Industry, CA
  • NPI 1164587507
  NPD (past)
• Jem Liu, PHARM.D.

  • Pharmacist
  • City of Industry, CA
  • NPI 1720362981
  NPD (past)
• Jer-Jie Liu, RPH

  • Pharmacist
  • City of Industry, CA
  • NPI 1881759173
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1508921891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18575 E. GALE AVE.",
            "address_2": "#158",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-965-5988",
            "fax_number": "626-965-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18575 E. GALE AVE.",
            "address_2": "#158",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-965-5988",
            "fax_number": "626-965-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCOURSE RX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CEO/CFO/SEC./DIR.",
        "authorized_official_telephone_number": "626-965-5988"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY46886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concourse Rx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concourse Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cole Vision Corporation
• Community Dental Services
• Complete Care Medical Associates, a Medical Corporation
• Vanessa Conchas
• Concourse Diagnostic and Surgery Center, LLC
• Tiffany Conejo
• Jill Garcia Cooper
• Ryan Alexander Cortez
• Yvonne Vanessa Cortez
• Ricki Corvera

• Pharmacy in City of Industry, CA
• Providers in City of Industry, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.