Family Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY49083 Issued in CA

Legal business name

FAMILY PHARMACY, INC.

Doing business as

Family Pharmacy

Practice address

1033 N Waterman Ave
Ste C
San Bernardino, CA 92410-3823

Phone

(909) 884-2739

Fax

(909) 885-8880

NPI assigned

Nov 15, 2005

Last updated

Mar 23, 2017By 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

Mr. Nguyen Duc Dao, PHARM DNPI 1417460247

Title

Vice President

Phone

(909) 884-2739

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 5

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.

• Nguyen D Dao, PHARM.D.

  • Pharmacist
  • San Bernardino, CA
  • NPI 1417460247
  NPD Authorized official
• Phuoc Tho Hoang

  • Pharmacist
  • San Bernardino, CA
  • NPI 1407445364
  NPD (past)
• Carolyn CHI Tran, RPH

  • Pharmacist
  • San Bernardino, CA
  • NPI 1578162582
  NPD (past)
• Khue Tran

  • Pharmacist
  • San Bernardino, CA
  • NPI 1881265999
  NPD (past)
• Ngoc M Tran

  • Pharmacist
  • San Bernardino, CA
  • NPI 1700351889
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1740262914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 N WATERMAN AVE",
            "address_2": "STE C",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103823",
            "telephone_number": "909-884-2739",
            "fax_number": "909-885-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 N WATERMAN AVE",
            "address_2": "STE C",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103823",
            "telephone_number": "909-884-2739",
            "fax_number": "909-885-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "DAO",
        "authorized_official_first_name": "NGUYEN",
        "authorized_official_middle_name": "DUC",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "909-884-2739",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740262914",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gloria Fajardo
• Noha Khalid Fakhoury, PHARMD
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• Community/Retail Pharmacy in San Bernardino, CA
• Providers in San Bernardino, 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 Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.