Organization Active NPI

Ihealth Max

Doing business as Homes Pharmacy

  • Community/Retail Pharmacy
  • Rancho Cucamonga, CA
National Provider Identifier
1932522505
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY51817 Issued in CA
Legal business name
IHEALTH MAX
Doing business as
Homes Pharmacy
Practice address
9713 Baseline Rd
Rancho Cucamonga, CA 91730-1408
Phone
(909) 989-8688
Fax
(909) 989-8665
NPI assigned
Feb 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Authorized official

Name
Yi Lin
Title
Owner / Pic
Phone
(909) 281-1681

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY51817 CA Primary

Addresses

Primary practice location

9713 Baseline Rd
Rancho Cucamonga, CA 91730-1408

Mailing address

9713 Baseline Rd
Rancho Cucamonga, CA 91730-1408
Phone (909) 989-8688

Other identifiers 2

IdentifierTypeStateIssuer
2144733OtherPK
1932522505MedicaidCA

Other names 1

  • Homes Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150219001028 CA Part B Supplier - Mass Immunization (Roster Biller Only) 6608191465 Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

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": "1391212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1932522505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9713 BASELINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301408",
            "telephone_number": "909-989-8688",
            "fax_number": "909-989-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9713 BASELINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301408",
            "telephone_number": "909-989-8688",
            "fax_number": "909-989-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHEALTH MAX",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-01",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "YI",
        "authorized_official_title_or_position": "OWNER / PIC",
        "authorized_official_telephone_number": "909-281-1681"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY51817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144733",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932522505",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homes Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.