Organization Active NPI

Shafter Medical Pharmacy, LLC

Doing business as Shafter Medical Pharmacy

  • Community/Retail Pharmacy
  • Shafter, CA
National Provider Identifier
1760684047
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
48539 Issued in CA
Legal business name
SHAFTER MEDICAL PHARMACY, LLC
Doing business as
Shafter Medical Pharmacy
Practice address
825 Central Valley Hwy
Suite a
Shafter, CA 93263-2003
Phone
(661) 746-5600
Fax
(661) 746-5600
NPI assigned
May 31, 2007
Last updated
May 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Iskander M Hussein, RPHNPI 1518333517
Title
President
Phone
(661) 746-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 48539 CA
Community/Retail Pharmacy 3336C0003X
Community/Retail Pharmacy 3336C0003X 48539 CA Primary
Home Infusion Therapy Pharmacy 3336H0001X 48539 CA
Specialty Pharmacy 3336S0011X 48539 CA
Compounding Pharmacy 3336C0004X 48539 CA

Addresses

Primary practice location

825 Central Valley Hwy
Suite a
Shafter, CA 93263-2003

Mailing address

825 Central Valley Hwy
Suite a
Shafter, CA 93263-2003
Phone (661) 746-5600

Other names 1

  • Shafter Medical Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161202000257 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4789889650 Practice locations: Shafter, CA

National Provider Directory

National Provider Directory

Locations

825 Central Valley Hwy
Ste A
Shafter, CA 93263
Phone (661) 746-5600

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1760684047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CENTRAL VALLEY HWY",
            "address_2": "SUITE A",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632003",
            "telephone_number": "661-746-5600",
            "fax_number": "661-746-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CENTRAL VALLEY HWY",
            "address_2": "SUITE A",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632003",
            "telephone_number": "661-746-5600",
            "fax_number": "661-746-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFTER MEDICAL PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "HUSSEIN",
        "authorized_official_first_name": "ISKANDER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-746-5600",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "48539",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "48539",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "CA",
            "license": "48539",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "48539",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "48539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shafter Medical Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shafter, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.

Verify at the official NPI Registry.