Organization Active NPI

JK Pharmacy Inc

Doing business as Chino Plaza Pharmacy

  • Long Term Care Pharmacy
  • Chino, CA
National Provider Identifier
1548960453
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
JK PHARMACY INC
Doing business as
Chino Plaza Pharmacy
Practice address
5562 Philadelphia St Ste 110
Chino, CA 91710-2482
Phone
(909) 464-0300
Fax
(909) 285-0991
NPI assigned
Mar 8, 2023
Last updated
Mar 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Authorized official

Name
Jay KimNPI 1508130840
Title
President
Phone
(909) 464-0300

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
Community/Retail Pharmacy 3336C0003X NU
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

5562 Philadelphia St Ste 110
Chino, CA 91710-2482

Mailing address

5562 Philadelphia St Ste 110
Chino, CA 91710-2482
Phone (909) 464-0300

Other identifiers 1

IdentifierTypeStateIssuer
CA339274MedicaidCA

Other names 1

  • CHINO PLAZA PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chino Plaza Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

5562 Philadelphia St
Ste 110
Chino, CA 91710
Phone (909) 464-0300

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1548960453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 110",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102482",
            "telephone_number": "909-464-0300",
            "fax_number": "909-285-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 110",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102482",
            "telephone_number": "909-464-0300",
            "fax_number": "909-285-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-464-0300"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA339274",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHINO PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.