Organization Active NPI

Pacific West Pharmacy Inc

  • Long Term Care Pharmacy
  • Rocklin, CA
National Provider Identifier
1902842396
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHY40592 Issued in CA
Legal business name
PACIFIC WEST PHARMACY INC
Doing business as
PACIFIC WEST PHARMACY
Practice address
4363 Pacific St
Rocklin, CA 95677-2117
Phone
(916) 632-7560
Fax
(916) 632-7571
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Arthur Whitney, RPH
Title
President
Phone
(916) 632-9311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PHY40592 CA Primary

Addresses

Primary practice location

4363 Pacific St
Rocklin, CA 95677-2117

Mailing address

4363 Pacific St
Rocklin, CA 95677-2117
Phone (916) 632-7560

Other identifiers 2

IdentifierTypeStateIssuer
PHA405920MedicaidCA
0591924OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • PACIFIC WEST PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210510002690 CA Part B Supplier - Pharmacy 2567583370 Practice locations: Rocklin, CA

National Provider Directory

National Provider Directory

Locations

4363 Pacific St
Rocklin, CA 95677
Phone (916) 632-7560

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Acc Care CenterSacramento, CA, CCN 555261 Skilled nursing facility Adp of the SNF Oct 25, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

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": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1902842396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 PACIFIC ST",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772117",
            "telephone_number": "916-632-7560",
            "fax_number": "916-632-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4363 PACIFIC ST",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772117",
            "telephone_number": "916-632-7560",
            "fax_number": "916-632-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC WEST PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-632-9311",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY40592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA405920",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0591924",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACIFIC WEST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocklin, CA

Sources for this page

Verify at the official NPI Registry.