Organization Active NPI

Peter Kwok

Doing business as Medicine Shoppe

  • Community/Retail Pharmacy
  • Fresno, CA
National Provider Identifier
1962514885
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PETER KWOK
Doing business as
Medicine Shoppe
Practice address
4845 E Butler Ave
Fresno, CA 93727-5015
Phone
(559) 255-3301
Fax
(559) 255-2912
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Peter Kwok, RPH
Title
Owner Pharmacist
Phone
(559) 255-3301

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY32411 CA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4845 E Butler Ave
Fresno, CA 93727-5015

Mailing address

4845 E Butler Ave
Fresno, CA 93727-5015

Other identifiers 2

IdentifierTypeStateIssuer
PHA34110MedicaidCA
0585325OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Medicine Shoppe Doing business as

National Provider Directory

National Provider Directory

Locations

4845 E Butler Ave
Fresno, CA 93727
Phone (209) 255-3301

Practitioners & affiliated clinicians

Practitioners 1

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1962514885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 E BUTLER AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937275015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 E BUTLER AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937275015",
            "telephone_number": "559-255-3301",
            "fax_number": "559-255-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER KWOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KWOK",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "559-255-3301",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY32411",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA34110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0585325",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.