Paradise Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55455 Issued in CA

Legal business name

PARADISE PHARMACY, INC.

Doing business as

Paradise Pharmacy

Practice address

502 Euclid Ave Ste 100
National City, CA 91950-2948

Phone

(619) 399-7581

Fax

(619) 399-7584

NPI assigned

Feb 21, 2017

Last updated

Jul 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rolanfrancis Legaspi

Title

Pharmd Owner

Phone

(619) 399-7581

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Paradise Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Paradise Pharmacy, Inc.

  dba Ivy Pharmacy

  • Pharmacy
  • San Diego, CA
  • NPI 1699550400

  3173052354

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Ivy 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.

• Paradise Pharmacy, Inc.

  dba Ivy Pharmacy

  • Pharmacy
  • San Diego, CA
  • NPI 1699550400
  NPD tax ID

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1619416773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 100",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502948",
            "telephone_number": "619-399-7581",
            "fax_number": "619-399-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 100",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502948",
            "telephone_number": "619-399-7581",
            "fax_number": "619-399-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "LEGASPI",
        "authorized_official_first_name": "ROLANFRANCIS",
        "authorized_official_title_or_position": "PHARMD OWNER",
        "authorized_official_telephone_number": "619-399-7581"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167997",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paradise Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angelina Eileen Palos
• Jay Pandhi, MD
• Monica Rae Paniagua
• Gregory Sean Paniccia, M.D.
• Paradise Family Health Center
• Paradise Valley Health Care Center, Inc. (Paradise Valley Health Care Center)
• Paradise Valley Hospital
• Paradise Valley Hospital
• Paradise Valley Hospital (Prime Ally Program)
• Paradise Valley Hospital

• Community/Retail Pharmacy in National City, CA
• Providers in National City, 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 Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.