Provider Type Icon

JFK MEDICAL PLAZA PHARMACY INC NPI 1700960838


NPI Information

NPI: 1700960838
Provider Name: JFK MEDICAL PLAZA PHARMACY INC
Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
41120 WASHINGTON ST
STE 100
BERMUDA DUNES, CA
ZIP 92203
Phone: (760) 772-7300
Get Directions

JFK MEDICAL PLAZA PHARMACY INC is a pharmacy in Bermuda Dunes, CA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. JFK MEDICAL PLAZA PHARMACY INC NPI is 1700960838. The provider is registered as an organization entity type.

The provider's business location address is:

41120 WASHINGTON ST
STE 100
BERMUDA DUNES, CA
ZIP 92203-215
Phone: (760) 772-7300
Fax: (760) 772-7303

The provider's authorized official is Young Cho .
The authorized official title is President and has the following contact phone number (760) 772-7300.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyPHY45002CALIFORNIAYes
23336C0003XPharmacyCommunity/Retail PharmacyX

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHY45002MEDICAIDCALIFORNIA
20544052OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.