Organization Active NPI

D & K Brothers Inc

Doing business as DK Pharmacy

  • Community/Retail Pharmacy
  • Rancho Cucamonga, CA
National Provider Identifier
1649672809
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY51916 Issued in CA
Legal business name
D & K BROTHERS INC
Doing business as
DK Pharmacy
Practice address
10431 Lemon Ave Ste G
Rancho Cucamonga, CA 91737-3763
Phone
(909) 493-1500
Fax
(909) 493-1501
NPI assigned
Sep 19, 2014
Last updated
Apr 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Authorized official

Name
Ashraf Elgamal, RPH
Title
Owner / Pic
Phone
(909) 527-3047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY51916 CA Primary

Addresses

Primary practice location

10431 Lemon Ave Ste G
Rancho Cucamonga, CA 91737-3763

Mailing address

10431 Lemon Ave
Ste G
Rancho Cucamonga, CA 91737-3700
Phone (909) 493-1500

Other identifiers 2

IdentifierTypeStateIssuer
2148019OtherPK
1649672809MedicaidCA

Other names 1

  • DK Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150226000180 CA Part B Supplier - Mass Immunization (Roster Biller Only) 6103142732 Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory
Tax ID family
D K Brothers Inc2 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.

Practitioners & affiliated clinicians

Practitioners 2

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": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1649672809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10431 LEMON AVE",
            "address_2": "STE G",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373700",
            "telephone_number": "909-493-1500",
            "fax_number": "909-493-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10431 LEMON AVE STE G",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373763",
            "telephone_number": "909-493-1500",
            "fax_number": "909-493-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D & K BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "ELGAMAL",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_title_or_position": "OWNER / PIC",
        "authorized_official_telephone_number": "909-527-3047",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY51916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148019",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649672809",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DK Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.