Organization Active NPI

MNK Pharmacy LLC

  • Community/Retail Pharmacy
  • San Ysidro, CA
National Provider Identifier
1649849183
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MNK PHARMACY LLC
Doing business as
Beyer Pharmacy
Practice address
4184 Beyer Blvd Ste 101
San Ysidro, CA 92173-2183
Phone
(619) 207-0406
Fax
(619) 271-3370
NPI assigned
Jun 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Dr. Mike Najah Katy, DRNPI 1144639303
Title
Owner
Phone
(248) 255-1058

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 1

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

Addresses

Primary practice location

4184 Beyer Blvd Ste 101
San Ysidro, CA 92173-2183

Mailing address

4184 Beyer Blvd Ste 101
San Ysidro, CA 92173-2183
Phone (619) 207-0406

Other names 1

  • Beyer Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230421002372 CA Part B Supplier - Pharmacy 4880059096 Practice locations: San Ysidro, CA

National Provider Directory

National Provider Directory

Locations

4184 Beyer Blvd
Ste 101
San Ysidro, CA 92173
Phone (619) 207-0406

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1624147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1649849183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4184 BEYER BLVD STE 101",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732183",
            "telephone_number": "619-207-0406",
            "fax_number": "619-271-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4184 BEYER BLVD STE 101",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732183",
            "telephone_number": "619-207-0406",
            "fax_number": "619-271-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MNK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-20",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "KATY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "NAJAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-255-1058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beyer Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Ysidro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.