NPIMap

Organization Active NPI

Triad Compounding Pharmacy

  • Pharmacist
  • Cerritos, CA
National Provider Identifier
1679865083
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29677 Issued in CA
Legal business name
TRIAD COMPOUNDING PHARMACY
Practice address
11090 Artesia Blvd
Suite H
Cerritos, CA 90703-2545
Phone
(562) 468-4311
Fax
(562) 468-4314
NPI assigned
May 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Authorized official

Name
Ronald S. Miller, PHARM.D.
Title
Manager
Phone
(562) 468-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 29677 CA Primary

Addresses

Primary practice location

11090 Artesia Blvd
Suite H
Cerritos, CA 90703-2545

Mailing address

11090 Artesia Blvd
Suite H
Cerritos, CA 90703-2545
Phone (562) 468-4311

National Provider Directory

National Provider Directory
Tax ID family
Artesia Pharmacy 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.

Locations

11090 Artesia Blvd
Ste H
Cerritos, CA 90703
Phone (562) 468-4311

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1679865083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11090 ARTESIA BLVD",
            "address_2": "SUITE H",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032545",
            "telephone_number": "562-468-4311",
            "fax_number": "562-468-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11090 ARTESIA BLVD",
            "address_2": "SUITE H",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032545",
            "telephone_number": "562-468-4311",
            "fax_number": "562-468-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "562-468-4311",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "29677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.