Provider Demographics
NPI:1437538691
Name:CJMBS PHARMACIES INC
Entity Type:Organization
Organization Name:CJMBS PHARMACIES INC
Other - Org Name:EL NORTE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-233-2100
Mailing Address - Street 1:125 W MISSION AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1721
Mailing Address - Country:US
Mailing Address - Phone:760-233-2100
Mailing Address - Fax:760-233-2105
Practice Address - Street 1:125 W MISSION AVE STE 105
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1721
Practice Address - Country:US
Practice Address - Phone:760-233-2100
Practice Address - Fax:760-233-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2152103OtherPK
CA1437538691Medicaid