CCF&K Limited Liability Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY51876 Issued in CA

Legal business name

CCF&K LIMITED LIABILITY COMPANY

Practice address

16070 Tuscola Rd Ste 102
Apple Valley, CA 92307-1691

Phone

(760) 242-2559

Fax

(760) 242-8070

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Clement Ajayi

Title

Owner

Phone

(760) 242-2559

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Community Care Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1750429411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16070 TUSCOLA RD STE 102",
            "address_2": "SUITE #102",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071691",
            "telephone_number": "760-242-2559",
            "fax_number": "760-242-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16070 TUSCOLA RD STE 102",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071691",
            "telephone_number": "760-242-2559",
            "fax_number": "760-242-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCF&K LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-242-2559"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY51876",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146438",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Apple Valley, CA
• Providers in Apple Valley, 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 May 1, 2017; 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.