Organization Active NPI

Mariarx Inc

  • Community/Retail Pharmacy
  • Garden Grove, CA
National Provider Identifier
1902179740
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MARIARX INC
Practice address
13872 Harbor Blvd Ste 1a
Garden Grove, CA 92843-4000
Phone
(714) 554-4754
Fax
(714) 554-4854
NPI assigned
Feb 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Kimberly Nguyen
Title
President/Ceo
Phone
(714) 554-4754

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

13872 Harbor Blvd Ste 1a
Garden Grove, CA 92843-4000

Mailing address

13872 Harbor Blvd Ste 1a
Garden Grove, CA 92843-4000
Phone (714) 554-4754

Other identifiers 2

IdentifierTypeStateIssuer
1902179740MedicaidCA
PHY58863OtherCABOARD OF PHARMACY

Other names 1

  • MARIA PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230414000381 CA DME Supplier - Pharmacy 9032584586 Practice locations: Garden Grove, CA
O20231003003867 CA Part B Supplier - Mass Immunization (Roster Biller Only) 9032584586 Practice locations: Garden Grove, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Maria Pharmacy13872 Harbor Blvd, Garden Grove, CA 92843-4000(714) 554-4754 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Mar 13, 2023

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1902179740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13872 HARBOR BLVD STE 1A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434000",
            "telephone_number": "714-554-4754",
            "fax_number": "714-554-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13872 HARBOR BLVD STE 1A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434000",
            "telephone_number": "714-554-4754",
            "fax_number": "714-554-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIARX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "714-554-4754"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902179740",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY58863",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARIA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARIA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.