Active NPI
Good Life Pharmacy Inc
- Community/Retail Pharmacy
- Long Beach, CA
National Provider Identifier
1730611559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- GOOD LIFE PHARMACY INC
- Doing business as
- AVIVA PHARMACY
- Practice address
- 2633 Atlantic Ave
Long Beach, CA 90806-2710 - Phone
- (562) 888-1277
- NPI assigned
- Mar 30, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Tu Amy Nguyen, PHARM.D.
- Title
- Ceo
- Phone
- (562) 888-1277
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
2633 Atlantic Ave
Long Beach, CA 90806-2710
Mailing address
2633 Atlantic Ave
Long Beach, CA 90806-2710
Phone (562) 888-1277
Other names 1
- AVIVA PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171207001385 | CA | DME Supplier - Pharmacy | 0446517049 | Practice locations: Long Beach, CA |
| O20180314002464 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0446517049 | Practice locations: Long Beach, CA |
| O20230113000539 | CA | Part B Supplier - Independent Clinical Laboratory | 0446517049 | Practice locations: Long Beach, CA |
National Provider Directory
National Provider Directory- Tax ID family
- Aviva Pharmacy
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Long Beach, CA
- NPI 1114667250
-
- Long Term Care Pharmacy
- Long Beach, CA
- NPI 1720732159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490832000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1651795200000",
"number": "1730611559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2633 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062710",
"telephone_number": "562-888-1277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2633 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062710",
"telephone_number": "562-888-1277"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOOD LIFE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-30",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "TU",
"authorized_official_middle_name": "AMY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "562-888-1277",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM.D."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "AVIVA PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "AVIVA PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.