P.S. Enterprise, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY45238 Issued in CA

Legal business name

P.S. ENTERPRISE, INC

Practice address

2300 Huntington Dr
San Marino, CA 91108-2641

Phone

(626) 287-9921

Fax

(626) 285-0644

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Phic Kaing Lim, PHRM D

Title

Owner

Phone

(626) 287-9921

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• HUNTINGTON PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1669569810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HUNTINGTON DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082641",
            "telephone_number": "626-287-9921",
            "fax_number": "626-285-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HUNTINGTON DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082641",
            "telephone_number": "626-287-9921",
            "fax_number": "626-285-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.S. ENTERPRISE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "PHIC KAING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-287-9921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHRM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY45238",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0524846",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA452380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUNTINGTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Deborah Palmer
• Jacqueline J Pardo, CCC-SLP
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• PCH Pasadena, LLC

• Community/Retail Pharmacy in San Marino, CA
• Providers in San Marino, 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 Mar 30, 2011; 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.