Innovation Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

INNOVATION PHARMACY INC.

Doing business as

Innovation Rx

Practice address

18102 Irvine Blvd Ste 102
Tustin, CA 92780-3423

Phone

(949) 340-1700

Fax

(949) 340-1699

NPI assigned

May 25, 2023

Last updated

Nov 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond Liu, PHARM.DNPI 1124848486

Title

Ceo

Phone

(949) 340-1700

Specialties & licenses 2

Addresses

Other names 1

• Innovation Rx Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

Innovation Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Innovation Pharmacy Inc.

  dba Innovation RX

  • Long Term Care Pharmacy
  • Tustin, CA
  • NPI 1194598060
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raymond Liu

  • Pharmacist
  • Tustin, CA
  • NPI 1124848486
  NPD Authorized official

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1710679766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD STE 102",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803423",
            "telephone_number": "949-340-1700",
            "fax_number": "949-340-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD STE 102",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803423",
            "telephone_number": "949-340-1700",
            "fax_number": "949-340-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-11-02",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-340-1700",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovation Rx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innovation Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Tustin, CA
• Providers in Tustin, 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 Nov 2, 2023; 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.