Good Samaritan Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

56061 Issued in CA

Legal business name

GOOD SAMARITAN PHARMACY INC

Practice address

8137 Malachite Ave Ste a
Rancho Cucamonga, CA 91730-3571

Phone

(909) 774-1115

Fax

(909) 774-1118

NPI assigned

Jan 22, 2018

Organization subpart

No

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

Authorized official

Name

Mylene Bunagan

Title

President

Phone

(909) 774-1115

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• GOOD SAMARITAN PHARMACY Other name

Tax ID family

Good Samaritan Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Good Samaritan Pharmacy Inc

  dba Good Samaritan Pharmacy

  • Long Term Care Pharmacy
  • San Dimas, CA
  • NPI 1538231311
  NPD tax ID

Locations

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525305600000",
    "number": "1548778723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8137 MALACHITE AVE STE A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303571",
            "telephone_number": "909-774-1115",
            "fax_number": "909-774-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8137 MALACHITE AVE STE A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303571",
            "telephone_number": "909-774-1115",
            "fax_number": "909-774-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-05-03",
        "status": "A",
        "authorized_official_last_name": "BUNAGAN",
        "authorized_official_first_name": "MYLENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-774-1115"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "56061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175562",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOOD SAMARITAN PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Long Term Care Pharmacy in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.