Anaheim Pharmacy, LLC
Pharmacy, Long Term Care Pharmacy in Anaheim, CA. Organization (NPI-2).
NPI number1114786241
StatusActive
Last updated in NPPESSep 29, 2025
Details
- NPI
- 1114786241
- Entity type
- Organization (NPI-2)
- Legal business name
- Anaheim Pharmacy, LLC
- Organization subpart
- No
- Enumeration date
- Mar 19, 2024
- Certification date
- Sep 29, 2025
- Last updated
- Sep 29, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – | Yes |
Other names
- Anaheim Pharmacy (Ltc) (Doing Business As)
Practice location
1211 W La Palma Ave Ste 102Anaheim, CA 92801-2809
Phone 714-442-1141 · Fax 714-442-1142
Mailing address
1211 W La Palma Ave Ste 102Anaheim, CA 92801-2809
Phone 714-442-1141 · Fax 714-442-1142
Authorized official
Jay Kim
Managing Member
9094640300
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 21 Long Term Care Pharmacy providers in Anaheim · All 11,123 providers in Anaheim
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