Organization Active NPI

Morningside Medical Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1982748430
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHA49269 Issued in CA
Legal business name
MORNINGSIDE MEDICAL PHARMACY, INC.
Practice address
1704 W Manchester Ave
Los Angeles, CA 90047-3034
Phone
(323) 753-1333
Fax
(323) 753-1335
NPI assigned
Feb 17, 2007
Last updated
Sep 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Mr. Remy Mgbojirikwe
Title
President
Phone
(323) 753-1333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHA49269 CA Primary

Addresses

Primary practice location

1704 W Manchester Ave
Los Angeles, CA 90047-3034

Mailing address

1704 W Manchester Ave
Los Angeles, CA 90047-3034
Phone (323) 753-1333

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200810001310 CA Part B Supplier - Pharmacy 4688099542 Practice locations: Los Angeles, CA
O20201029002318 CA DME Supplier - Pharmacy 4688099542 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
Morningside Medical Pharmacy Inc2 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.

Locations

1704 W Manchester Ave
Ste 100
Los Angeles, CA 90047
Phone (323) 753-1333

Practitioners & affiliated clinicians

Practitioners 1

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": "1171670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1982748430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-753-1333",
            "fax_number": "323-753-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-753-1333",
            "fax_number": "323-753-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORNINGSIDE MEDICAL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-17",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "MGBOJIRIKWE",
        "authorized_official_first_name": "REMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-753-1333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHA49269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.