Tilton Nguyen Pharmaceutical Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

53859 Issued in CA

Legal business name

TILTON NGUYEN PHARMACEUTICAL INC

Doing business as

Oasis Pharmacy

Practice address

15433 W Sand St Ste 102
Victorville, CA 92392-2903

Phone

(760) 241-4080

Fax

(760) 241-4171

NPI assigned

Feb 16, 2013

Organization subpart

No

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

Authorized official

Name

Pauline Tilton

Title

Pharmacist in Charge

Phone

(760) 241-4080

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Oasis Pharmacy Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1720328453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15433 W SAND ST STE 102",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922903",
            "telephone_number": "760-241-4080",
            "fax_number": "760-241-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15433 W SAND ST STE 102",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922903",
            "telephone_number": "760-241-4080",
            "fax_number": "760-241-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILTON NGUYEN PHARMACEUTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-16",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "TILTON",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "760-241-4080"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "53859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138994",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720328453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oasis Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pauline Minh Tilton, PHARM. D.
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• Carlos Tirado
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• Community/Retail Pharmacy in Victorville, CA
• Providers in Victorville, 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 Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.