Western Pharmacy Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55904 Issued in CA

Legal business name

WESTERN PHARMACY GROUP LLC

Practice address

610 Gateway Center Way
Ste a
San Diego, CA 92102-4533

Phone

(619) 262-4373

Fax

(619) 263-1557

NPI assigned

Feb 14, 2011

Organization subpart

No

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

Authorized official

Name

Kevin Faris

Title

Ceo

Phone

(360) 220-4818

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDICAL CENTER PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1821395609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 COHO WAY STE 312",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252066",
            "telephone_number": "360-685-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 GATEWAY CENTER WAY",
            "address_2": "STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024533",
            "telephone_number": "619-262-4373",
            "fax_number": "619-263-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PHARMACY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "FARIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-220-4818"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Pharmacy Group LLC
• Western Specialty Group L.P.
• John Robert Western, PA
• Hazel Westervelt
• Robert Westervelt
• Doribeth Westfall

• Community/Retail Pharmacy in San Diego, CA
• Providers in San Diego, 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 Jul 19, 2018; 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.