Organization Active NPI

LTC Pharmacy Ventures Corp

  • Long Term Care Pharmacy
  • El Cajon, CA
National Provider Identifier
1700660263
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LTC PHARMACY VENTURES CORP
Practice address
161 E Main St Ste 104
El Cajon, CA 92020-3993
Phone
(858) 878-4150
Fax
(858) 878-4152
NPI assigned
Aug 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Yefim Iskhakov
Title
President/Ceo
Phone
(858) 878-4150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

161 E Main St Ste 104
El Cajon, CA 92020-3993

Mailing address

161 E Main St Ste 104
El Cajon, CA 92020-3993
Phone (858) 878-4150

Other identifiers 1

IdentifierTypeStateIssuer
PHY60529OtherCABOARD OF PHARMACY

Other names 1

  • STAR LTC PHARMACY SD Doing business as

National Provider Directory

National Provider Directory

Locations

1525 W 13th St
Ste B
Upland, CA 91786
Phone (909) 931-9019

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1700660263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST STE 104",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203993",
            "telephone_number": "858-878-4150",
            "fax_number": "858-878-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST STE 104",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203993",
            "telephone_number": "858-878-4150",
            "fax_number": "858-878-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC PHARMACY VENTURES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "ISKHAKOV",
        "authorized_official_first_name": "YEFIM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "858-878-4150"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY60529",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STAR LTC PHARMACY SD",
            "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 Feb 3, 2025; 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.