IMGRX SJ VALLEY (NPI# 1871695130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871695130 |
| Entity Type | Organization |
| Organization Name | IMGRX SJ VALLEY |
| Other Organization Name | UNITED HEALTH CENTERS PHARMACY MENDOTA |
| Practice Address |
121 Barboza St Building 3 Mendota CA 93640-1901 |
| Mailing Address |
815 Brazos St. Suite 900 Austin TX 78701 |
| Practice Telephone | 5596555000 |
| Practice Fax Number | 7608593614 |
| Mailing Telephone | 5125962930 |
| Mailing Fax Number | 5122335828 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2017-08-09 |
| Authorized Official Name | KEVIN REW (GENERAL COUNSEL & COO) |
| Authorized Official Telephone | 5125962930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY 54517 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHA462340 | 05 |
| Other Name | Type Code |
|---|---|
| United Health Centers Pharmacy Mendota | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194825265 | Imgrx Sj Valley | Pharmacy | 445 11th Street, Orange Cove, CA 93646 | 2006-09-25 |
| 1013024132 | Imgrx Sj Valley | Pharmacy | 650 Zediker Avenue, Parlier, CA 93648 | 2006-08-24 |
| 1316294598 | Imgrx Sj Valley | Pharmacy | 476 E Washington Ave, Earlimart, CA 93219 | 2012-08-07 |
| 1962504225 | Imgrx Sj Valley | Pharmacy | 517 S Madera Ave, Kerman, CA 93630-1523 | 2006-09-05 |
| Street Address |
121 BARBOZA ST BUILDING 3 |
| City | MENDOTA |
| State | CA |
| Zip Code | 93640-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184606634 | United Health Centers of The San Joaquin Valley | Clinic/Center | 121 Barboza St, Mendota, CA 93640-1901 | 2005-11-18 |
| 1497377048 | Brandon Wong | Physician Assistant | 121 Barboza St, Mendota, CA 93640-1901 | 2020-05-16 |
| 1326604364 | Karen Ashley Merriweather | Dentist | 121 Barboza St, Mendota, CA 93640-1901 | 2019-05-15 |
| 1184148744 | Joanna Fabris | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2017-07-26 |
| 1376956235 | Mandeep Kaur | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2014-06-09 |
| 1205255817 | Sonia Fabionar Relingo | Dentist | 121 Barboza St, Mendota, CA 93640-1901 | 2014-04-10 |
| 1609210830 | Raman Mattu | Internal Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2013-04-18 |
| 1366798530 | Kongsab La Hatlavongsa | Dentist | 121 Barboza St, Mendota, CA 93640-1901 | 2012-07-25 |
| 1134420144 | Shila Shafii Noori | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2010-11-08 |
| 1588836688 | Kristen Marie Stockamp | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2008-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243782 | Turning Point of Central California, Inc. | Community/Behavioral Health | 121 Belmont Ave. Ste 300, Mendota, CA 93640 | 2020-07-30 |
| 1881232676 | Madera Community Hospital | Clinic/Center | 121 Belmont Ave., Suite 101, Mendota, CA 93640 | 2019-12-12 |
| 1912465626 | Gayathri Parameswaran Iyer | Dentist | United Health Centers, 121 Barboza St, Mendota, CA 93640 | 2019-03-12 |
| 1801372594 | Fresno County Superintendent of Schools | Psychologist | 121 Belmont Avenue, Mendota, CA 93640 | 2018-07-16 |
| 1730488180 | Promesa Behavioral Health | Community/Behavioral Health | 1258 E. Belmont Avenue, Mendota, CA 93640 | 2011-03-24 |
| 1689809097 | Fresno County Behavioral Health | Clinic/Center | 121 Barbosa St., Mendota, CA 93640 | 2009-05-29 |
| 1760826754 | Mendota Unified School District | Local Education Agency (LEA) | 115 Mccabe Ave, Mendota, CA 93640-2000 | 2013-04-22 |
| 1659874584 | Nayeli Baez | Behavior Technician | 595 I St, Mendota, CA 93640-2121 | 2018-03-16 |
| 1386942316 | Promesa Behavioral Health | Community/Behavioral Health | 211 Smoot Ave, Mendota, CA 93640-2234 | 2011-02-28 |
| 1881780757 | Pharmkee, Inc. | Durable Medical Equipment & Medical Supplies | 497 Oller St, Mendota, CA 93640-2312 | 2006-10-05 |
| Find all providers in zip 93640 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376646042 | Highland Park Cvs, L.L.C. | Pharmacy | 1116 Meriden St, Mendota, IL 61342-1054 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.