Ionia Pharmacy, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY50802 Issued in CA

Legal business name

IONIA PHARMACY, LLC

Doing business as

Ionia Pharmacy

Practice address

15421 Red Hill Ave
Tustin, CA 92780-7309

Phone

(714) 408-7628

Fax

(855) 884-6642

NPI assigned

May 9, 2012

Last updated

May 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alison Cherney

Title

Ceo

Phone

(615) 319-8126

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ionia Pharmacy Doing business as

Tax ID family

Ionia 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.

• Ionia Pharmacy, LLC

  dba Ionia Pharmacy

  • Compounding Pharmacy
  • Tustin, CA
  • NPI 1881950178
  NPD tax ID

Locations

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1912266172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 CONCORD PASS",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273706",
            "telephone_number": "615-319-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15421 RED HILL AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807309",
            "telephone_number": "714-408-7628",
            "fax_number": "855-884-6642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IONIA PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "CHERNEY",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-319-8126"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY50802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5643728",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ionia Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Tustin, CA
• Providers in Tustin, CA by specialty
• Compounding Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.