NPIMap

Organization Active NPI

Imgrx SJ Valley, Inc.

Doing business as United Health Centers Pharmacy Huron

  • Community/Retail Pharmacy
  • Huron, CA
National Provider Identifier
1710087887
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
54516 Issued in CA
Legal business name
IMGRX SJ VALLEY, INC.
Doing business as
United Health Centers Pharmacy Huron
Practice address
17008 13TH St.
Pharmacy Suite
Huron, CA 93234
Phone
(559) 945-2541
Fax
(559) 942-8016
NPI assigned
Sep 25, 2006
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
IMGRX SJ VALLEY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 54516 CA Primary

Addresses

Primary practice location

17008 13TH St.
Pharmacy Suite
Huron, CA 93234

Mailing address

Attn: CHC Retail Pharmacy Dept. 13651 Dublin CT
Stafford, TX 77477
Phone (281) 749-4000

Other identifiers 1

IdentifierTypeStateIssuer
PHA331050MedicaidCA

Other names 1

  • United Health Centers Pharmacy Huron Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imgrx SJ Valley Inc11 organizations share this tax ID, including this one
Part of
Imgrx SJ Valley Inc

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1710087887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: CHC RETAIL PHARMACY DEPT. 13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "281-749-4000",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17008 13TH ST.",
            "address_2": "PHARMACY SUITE",
            "city": "HURON",
            "state": "CA",
            "postal_code": "93234",
            "telephone_number": "559-945-2541",
            "fax_number": "559-942-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMGRX SJ VALLEY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMGRX SJ VALLEY, INC.",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-14",
        "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": "54516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA331050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Health Centers Pharmacy Huron",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "United Health Centers Pharmacy Huron",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huron, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.