J & R PHARMACY P C NPI 1306224662

NPI Information

NPI: 1306224662
Provider Name: J & R PHARMACY P C
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Doing Business As: JC NEIGHBORHOOD PHARMACY
CLIA Number: 05D2229893
Address: 770 MAGNOLIA AVE STE 1G
CORONA, CA
ZIP 92879
Phone: (951) 531-8041

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NPI Details

J & R PHARMACY P C is a durable medical equipment medical supplies in Corona, CA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. J & R PHARMACY P C NPI is 1306224662. The provider is registered as an organization entity type.
The provider Is Doing Business As Jc Neighborhood Pharmacy.

The provider's business location address is:

770 MAGNOLIA AVE STE 1G
CORONA, CA
ZIP 92879-121
Phone: (951) 531-8041
Fax: (951) 531-8043

The provider's authorized official is Jacqueline Ibrahim .
The authorized official title is Ceo/pic and has the following contact phone number (951) 531-8041.

The CLIA number assigned to this NPI record is 05D2229893 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/7/2015 and was last updated on 5/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	333600000X	Pharmacy				No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy	PHY55570	CALIFORNIA	No
3	332B00000X	Durable Medical Equipment & Medical Supplies				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1780273425	MEDICAID	CALIFORNIA
2	1780273425	OTHER	CALIFORNIA	IMMUNIZATION
3	1306224662	MEDICAID	CALIFORNIA
4	2151943	OTHER		PK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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