Organization Active NPI

Econo Pharmacy Inc

  • Community/Retail Pharmacy
  • Gardena, CA
National Provider Identifier
1912610106
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ECONO PHARMACY INC
Practice address
15435 S Western Ave
Gardena, CA 90249-4323
Phone
(714) 423-0632
NPI assigned
Jan 3, 2023
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Jinhee Moon Suh, PHARMD
Title
Pharmacist-in-Charge
Phone
(714) 423-0632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

15435 S Western Ave
Gardena, CA 90249-4323

Mailing address

15435 S Western Ave
Gardena, CA 90249-4323
Phone (714) 423-0632

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230627003515 CA Part B Supplier - Pharmacy 1759749476 Practice locations: Gardena, CA
O20241115002106 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1759749476 Practice locations: Gardena, CA

National Provider Directory

National Provider Directory

Locations

15435 S Western Ave
Ste 100C
Gardena, CA 90249
Phone (310) 353-2695

Practitioners & affiliated clinicians

Practitioners 2

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": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1912610106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15435 S WESTERN AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494323",
            "telephone_number": "714-423-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15435 S WESTERN AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494323",
            "telephone_number": "714-423-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECONO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "SUH",
        "authorized_official_first_name": "JINHEE",
        "authorized_official_middle_name": "MOON",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "714-423-0632",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.