Vernon Central Botica Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY40007 Issued in CA

Legal business name

VERNON CENTRAL BOTICA PHARMACY INC

Practice address

4375 S Central Ave
Los Angeles, CA 90011-3526

Phone

(323) 231-8992

Fax

(323) 231-7543

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Isaac LeeNPI 1396119756

Title

Owner

Phone

(323) 231-8992

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Vernon Central Botica Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Isaac Lee

  • Pharmacist
  • Los Angeles, CA
  • NPI 1396119756
  NPD Authorized official
• Wang Soo Lee

  • Pharmacist
  • Los Angeles, CA
  • NPI 1578711412
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1689742058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90011",
            "telephone_number": "323-231-8992",
            "fax_number": "323-231-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113526",
            "telephone_number": "323-231-8992",
            "fax_number": "323-231-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON CENTRAL BOTICA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-231-8992"
    },
    "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": "PHY40007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2000295",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689742058",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA400070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vernon Central Botica Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vernon Central Botica Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vermont V.O. Pharmacy, Inc.
• Vermont Village Community Development Corporation
• Vermont Workers Comp Center, Inc.
• Vermontcare Center
• Sarah Elizabeth Vermuele, DC
• Vernon Convalescent Hospital
• Vernon Healthcare Center, LLC
• Vernon J Knudson
• Vernon Medical Group Inc
• Alyssa Briana Vernon, FNP-C

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, 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 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.