Professional Village Pharmacy, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROFESSIONAL VILLAGE PHARMACY, INC.

Practice address

1701 Professional Dr
Sacramento, CA 95825-2104

Phone

(916) 483-3455

Fax

(916) 483-6745

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Clarke Richards IV, PHARM.D.NPI 1023197563

Title

Secretary/Cfo

Phone

(916) 483-3455

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• John Clarke Richards IV, PHARM.D.

  • Pharmacist
  • Sacramento, CA
  • NPI 1023197563
  NPD Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639262256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 PROFESSIONAL DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252104",
            "telephone_number": "916-483-3455",
            "fax_number": "916-483-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 PROFESSIONAL DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252104",
            "telephone_number": "916-483-3455",
            "fax_number": "916-483-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL VILLAGE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CLARKE",
        "authorized_official_title_or_position": "SECRETARY/CFO",
        "authorized_official_telephone_number": "916-483-3455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0573077",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA469970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.