Organization Active NPI

Apple Pharmacy Inc

Doing business as ABC Pharmacy

  • Pharmacy
  • Montclair, CA
National Provider Identifier
1912415118
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
55887 Issued in CA
Legal business name
APPLE PHARMACY INC
Doing business as
ABC Pharmacy
Practice address
5050 San Bernardino St Ste 110
Montclair, CA 91763-2326
Phone
(909) 264-1331
Fax
(909) 330-0933
NPI assigned
Jan 22, 2018
Last updated
Jan 22, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
APPLE PHARMACY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Dr. Alyssa Tamura, PHARMDNPI 1952819773
Title
Pharmacist
Phone
(909) 546-1000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 55887 CA Primary
Community/Retail Pharmacy 3336C0003X 55887 CA

Addresses

Primary practice location

5050 San Bernardino St Ste 110
Montclair, CA 91763-2326

Mailing address

5050 San Bernardino St Ste 110
Montclair, CA 91763-2326

Other identifiers 1

IdentifierTypeStateIssuer
55883OtherCAPHARMACY LICENSE

Other names 1

  • ABC Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180918004211 CA Part B Supplier - Pharmacy 7911258777 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Laguna Hills, CA; Montclair, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Apple Pharmacy Inc2 organizations share this tax ID, including this one
Part of
Apple Pharmacy Inc

Other organizations with this tax ID 1

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

Locations

5050 San Bernardino St
Ste 110
Montclair, CA 91763
Phone (909) 264-1331

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1912415118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SAN BERNARDINO ST STE 110",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SAN BERNARDINO ST STE 110",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632326",
            "telephone_number": "909-264-1331",
            "fax_number": "909-330-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLE PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPLE PHARMACY INC.",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "TAMURA",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "909-546-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "55887",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55887",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "55883",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.