Imgrx Slo, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54596 Issued in CA

Legal business name

IMGRX SLO, INC.

Doing business as

CHC Pharmacy Paso Robles

Practice address

2800 Riverside Ave Ste 150
Paso Robles, CA 93446-1311

Phone

(512) 596-2930

Fax

(805) 226-1197

NPI assigned

Aug 3, 2016

Organization subpart

Yes

Parent organization

IMGRX SLO, INC.As reported in NPPES

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

Authorized official

Name

Michael Brown

Title

Vice President, Managed Services

Phone

(281) 749-4764

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CHC Pharmacy Paso Robles Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Imgrx Slo, Inc.

  dba CHC Pharmacy SLO

  • Community/Retail Pharmacy
  • San Luis Obispo, CA
  • NPI 1225582570

  O20250321000361

  Same enrollment
• Imgrx Slo, Inc.

  dba CHC Templeton Pharmacy

  • Community/Retail Pharmacy
  • Templeton, CA
  • NPI 1558976761

  O20250321000361

  Same enrollment

Tax ID family

Imgrx Slo Inc3 organizations share this tax ID, including this one

Part of

Imgrx Slo Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Imgrx Slo, Inc.

  dba CHC Pharmacy SLO

  • Community/Retail Pharmacy
  • San Luis Obispo, CA
  • NPI 1225582570
  NPD tax ID
• Imgrx Slo, Inc.

  dba CHC Templeton Pharmacy

  • Community/Retail Pharmacy
  • Templeton, CA
  • NPI 1558976761
  NPD tax ID

Locations

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1689128936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774317",
            "telephone_number": "281-749-2547",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 RIVERSIDE AVE STE 150",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934461311",
            "telephone_number": "512-596-2930",
            "fax_number": "805-226-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMGRX SLO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMGRX SLO, INC.",
        "enumeration_date": "2016-08-03",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED SERVICES",
        "authorized_official_telephone_number": "281-749-4764"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164367",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC Pharmacy Paso Robles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHC Pharmacy Paso Robles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Housing Authority of San Luis Obispo
• Lucy Huffman, AMFT
• William Huiras, DDS
• Mitchell Drew Humphrys, MSW
• Warren Eugene Icke, PHD
• Mark A Iversen, D.D.S.
• J Brent Meek O D Inc
• Jack Heaslet Chiropractic Inc
• Jacob Wood Dental Corporation (Gateway Dental Practice)
• Monika Jagger

• Community/Retail Pharmacy in Paso Robles, CA
• Providers in Paso Robles, 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 Sep 15, 2022; 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.