NPIMap

Organization Active NPI

San Antonio Pharmacy

  • Community/Retail Pharmacy
  • Pomona, CA
National Provider Identifier
1790111235
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
51533 Issued in CA
Legal business name
SAN ANTONIO PHARMACY
Practice address
255 E Bonita Ave
Building 1, Suite 102
Pomona, CA 91767-1923
Phone
(909) 962-6430
NPI assigned
Sep 16, 2013
Organization subpart
Yes
Parent organization
SAN ANTONIO REGIONAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Mr. Harris Koenig
Title
President/Ceo
Phone
(909) 985-2811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 51533 CA Primary

Addresses

Primary practice location

255 E Bonita Ave
Building 1, Suite 102
Pomona, CA 91767-1923

Mailing address

255 E Bonita Ave
Building 1, Suite 102
Pomona, CA 91767-1923
Phone (909) 962-6430

National Provider Directory

National Provider Directory
Tax ID family
San Antonio Comm Hosp Phcy6 organizations share this tax ID, including this one
Part of
San Antonio Comm Hosp Phcy

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1790111235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "address_2": "BUILDING 1, SUITE 102",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-962-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE",
            "address_2": "BUILDING 1, SUITE 102",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-962-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN ANTONIO REGIONAL HOSPITAL INC",
        "enumeration_date": "2013-09-16",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-985-2811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "51533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.