Active NPI
San Antonio Infusion Pharmacy
- Home Infusion Therapy Pharmacy
- Ontario, CA
National Provider Identifier
1669513529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Therapy Pharmacy
- License
- PHY48866
- Legal business name
- SAN ANTONIO INFUSION PHARMACY
- Practice address
- 105 W B St
Ontario, CA 91762-3502 - Phone
- (909) 988-0591
- Fax
- (909) 988-0891
- NPI assigned
- Feb 12, 2007
- Organization subpart
- Yes
- Parent organization
- GEMMEL PHARMACY, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Allen Scorsatto
- Title
- Director of Pham Opr
- Phone
- (909) 984-7132
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | |||
| Compounding Pharmacy | 3336C0004X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X | PHY48866 | CA | Primary |
Addresses
Primary practice location
105 W B St
Ontario, CA 91762-3502
Mailing address
105 W B St
Ontario, CA 91762-3502
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0537247 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 0537247 | Other | OTHER ID NUMBER | |
| 1669513529 | Medicaid | CA |
National Provider Directory
National Provider Directory- Part of
- Sunny Hills Pharmacy
Locations
105 W B St
Ontario, CA 91762
Phone (909) 988-0591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213142400000",
"number": "1669513529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 W B ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917623502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 W B ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917623502",
"telephone_number": "909-988-0591",
"fax_number": "909-988-0891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAN ANTONIO INFUSION PHARMACY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GEMMEL PHARMACY, INC.",
"enumeration_date": "2007-02-12",
"last_updated": "2008-06-11",
"status": "A",
"authorized_official_last_name": "SCORSATTO",
"authorized_official_first_name": "ALLEN",
"authorized_official_title_or_position": "DIRECTOR OF PHAM OPR",
"authorized_official_telephone_number": "909-984-7132"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": "CA",
"license": "PHY48866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0537247",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER",
"identifier": "0537247",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669513529",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.