NPIMap

Organization Active NPI

Abc Pharmacy

  • Mail Order Pharmacy
  • Rancho Cucamonga, CA
National Provider Identifier
1871967315
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
63648 Issued in CA
Legal business name
ABC PHARMACY
Practice address
7974 Haven Ave
120
Rancho Cucamonga, CA 91730-3052
Phone
(877) 222-4598
NPI assigned
Nov 20, 2015
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Jonathan Michael Chan, PHARMDNPI 1750923595
Title
Pharmacist-in-Charge
Phone
(909) 285-1118

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X 63648 CA Primary
Mail Order Pharmacy 3336M0002X 006449 AZ
Mail Order Pharmacy 3336M0002X 03414 NV

Addresses

Primary practice location

7974 Haven Ave
120
Rancho Cucamonga, CA 91730-3052

Mailing address

7974 Haven Ave
120
Rancho Cucamonga, CA 91730-3052
Phone (877) 222-4598

Other identifiers 1

IdentifierTypeStateIssuer
1245676618MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Abc Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7974 Haven Ave
Ste 120
Rancho Cucamonga, CA 91730
Phone (877) 222-4598

Practitioners & affiliated clinicians

Practitioners 1

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": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1871967315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303052",
            "telephone_number": "877-222-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303052",
            "telephone_number": "877-222-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "909-285-1118",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "CA",
            "license": "63648",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "AZ",
            "license": "006449",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NV",
            "license": "03414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245676618",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.