Organization Active NPI

Border Village Pharmacy Inc

  • Community/Retail Pharmacy
  • El Cajon, CA
National Provider Identifier
1689145120
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BORDER VILLAGE PHARMACY INC
Practice address
891 Jackman St
El Cajon, CA 92020-3052
Phone
(619) 303-8800
NPI assigned
Dec 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Leonid Davydov
Title
Ceo/Pic
Phone
(619) 303-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

891 Jackman St
El Cajon, CA 92020-3052

Mailing address

891 Jackman St
El Cajon, CA 92020-3052
Phone (619) 303-8800

Other names 1

  • WORLD PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241113000860 CA Part B Supplier - Pharmacy 1850624156 Practice locations: El Cajon, CA

National Provider Directory

National Provider Directory

Locations

4630 Border Village Rd
Ste H1
San Ysidro, CA 92173
Phone (619) 428-3772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1689145120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 JACKMAN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203052",
            "telephone_number": "619-303-8800",
            "fax_number": "619-303-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 JACKMAN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203052",
            "telephone_number": "619-303-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORDER VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "CEO/PIC",
        "authorized_official_telephone_number": "619-303-8800"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WORLD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.