Porterville Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55892 Issued in CA

Legal business name

PORTERVILLE PHARMACY INC

Doing business as

Porterville Pharmacy # 2

Practice address

1270 W Henderson Ave
Porterville, CA 93257-1455

Phone

(559) 793-4410

Fax

(559) 782-9091

NPI assigned

Jan 16, 2018

Last updated

Jan 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Adly Mikhael

Title

Owner

Phone

(951) 750-9050

Specialties & licenses 1

Addresses

Other names 1

• Porterville Pharmacy # 2 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Porterville Pharmacy Inc

  • Community/Retail Pharmacy
  • Porterville, CA
  • NPI 1184083644

  O20160719002498

  Same enrollment

Locations

Practitioners 1

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.

• Marianna Mikhael

  • Pharmacist
  • Porterville, CA
  • NPI 1760155048
  NPD (past)

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1679081442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 W HENDERSON AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932571455",
            "telephone_number": "559-793-4410",
            "fax_number": "559-782-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 W HENDERSON AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932571455",
            "telephone_number": "559-793-4410",
            "fax_number": "559-782-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERVILLE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "MIKHAEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ADLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-750-9050"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porterville Pharmacy # 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Porterville Unified School District
• Porterville Valley Promptcare Medical
• Porterville Women's Medical Associates

• Community/Retail Pharmacy in Porterville, CA
• Providers in Porterville, 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 Jan 16, 2018; 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.