Advanced Pharmacy Group Inc.

Key facts

NPI: 1609258383
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
License: PHY56052 (CA)
Legal business name: ADVANCED PHARMACY GROUP INC.
Practice address: 15555 Main St., #D8
Hesperia, CA 92345-3423
Phone: (760) 987-4854
Fax: (760) 948-2000
NPI assigned: Jun 18, 2015
Organization subpart: No

Authorized official

Name: Husam Abukhiran NPI 1295139343
Title: Secretary
Phone: (760) 987-4854

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

Corporate family (same tax ID) 1

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

Advanced Pharmacy Group Inc. Long Term Care Pharmacy · Hesperia, CA · NPI 1588444731

NPD tax ID

Practitioners 1

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

Husam Abukhiran Pharmacist · Hesperia, CA · NPI 1295139343

NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20201116002797	CA	Part B Supplier - Mass Immunization (Roster Biller Only)	0941611396	Practice locations: Hesperia, CA

National Provider Directory

Tax ID family: Advanced Pharmacy Group Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Clinic/Center	261QP2300X
Clinic Pharmacy	3336C0002X
Community/Retail Pharmacy	3336C0003X	PHY56052	CA	Yes

Addresses

Primary practice location

15555 Main St., #D8
Hesperia, CA 92345-3423

Mailing address

15555 Main St., #D8
Hesperia, CA 92345-3423
Phone (760) 987-4854

Other names

Medicine Shoppe Doing business as

Other providers in Hesperia, CA

All providers in Hesperia, CA · Community/Retail Pharmacy in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.