Organization Active NPI

Pharmacorp, Inc

  • Community/Retail Pharmacy
  • Santa Monica, CA
National Provider Identifier
1831254747
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY41968 Issued in CA
Legal business name
PHARMACORP, INC
Practice address
2530B San Vicente Blvd
Santa Monica, CA 90402-2321
Phone
(310) 393-0201
Fax
(310) 394-2712
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Dr. Homayoun Namjo, PHARM.DNPI 1427531672
Title
President
Phone
(310) 393-0202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY41968 CA Primary

Addresses

Primary practice location

2530B San Vicente Blvd
Santa Monica, CA 90402-2321

Mailing address

2530B San Vicente Blvd
Santa Monica, CA 90402-2321
Phone (310) 393-0201

Other identifiers 2

IdentifierTypeStateIssuer
0578558OtherCANCPDP
1831254747MedicaidCA

Other names 2

  • Brentwood Pharmacy Doing business as
  • PharmaCorp, Inc. Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL E-Script Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210413001422 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4880002856 Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

214 26th St
Santa Monica, CA 90402

2530B San Vicente Blvd
Santa Monica, CA 90402
Phone (310) 393-0201

2530 San Vicente Blvd
#B
Santa Monica, CA 90402
Phone (310) 344-8586

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1831254747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530B SAN VICENTE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022321",
            "telephone_number": "310-393-0201",
            "fax_number": "310-394-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530B SAN VICENTE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022321",
            "telephone_number": "310-393-0201",
            "fax_number": "310-394-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACORP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "NAMJO",
        "authorized_official_first_name": "HOMAYOUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-393-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY41968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0578558",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831254747",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "E-Script",
            "affiliation": "N",
            "endpointDescription": "Electronic Prescribing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "2530B San Vicente Blvd",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904022321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brentwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PharmaCorp, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.