NPIMap

Organization Active NPI

Pacific Pharmacy Group

Doing business as Fallbrook LTC Pharmacy

  • Long Term Care Pharmacy
  • Fallbrook, CA
National Provider Identifier
1730526781
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
51247 Issued in CA
Legal business name
PACIFIC PHARMACY GROUP
Doing business as
Fallbrook LTC Pharmacy
Practice address
343 E Alvarado St
Suite C
Fallbrook, CA 92028-2966
Phone
(760) 728-6142
Fax
(760) 728-6382
NPI assigned
May 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Authorized official

Name
Jan Balthasar
Title
Ceo
Phone
(949) 215-5522

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X 51247 CA Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

343 E Alvarado St
Suite C
Fallbrook, CA 92028-2966

Mailing address

343 E Alvarado St
Suite C
Fallbrook, CA 92028-2966
Phone (760) 728-6142

Other identifiers 1

IdentifierTypeStateIssuer
2140772OtherPK

Other names 1

  • Fallbrook LTC Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pacific Pharmacy Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

343 E Alvarado St
Ste C
Fallbrook, CA 92028
Phone (760) 728-6142

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371168000000",
    "number": "1730526781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 E ALVARADO ST",
            "address_2": "SUITE C",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920282966",
            "telephone_number": "760-728-6142",
            "fax_number": "760-728-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E ALVARADO ST",
            "address_2": "SUITE C",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920282966",
            "telephone_number": "760-728-6142",
            "fax_number": "760-728-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PHARMACY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-06-14",
        "status": "A",
        "authorized_official_last_name": "BALTHASAR",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-215-5522"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "51247",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140772",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fallbrook LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; 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.