Provider Demographics
NPI:1700214046
Name:CJMBS PHARMACIES INC
Entity Type:Organization
Organization Name:CJMBS PHARMACIES INC
Other - Org Name:COMMUNITY PHARMACY OF VALLEY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:K
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:760-749-1156
Mailing Address - Street 1:29105 VALLEY CENTER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-6588
Mailing Address - Country:US
Mailing Address - Phone:760-749-1156
Mailing Address - Fax:760-749-1921
Practice Address - Street 1:29105 VALLEY CENTER RD STE 100
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6588
Practice Address - Country:US
Practice Address - Phone:760-749-1156
Practice Address - Fax:760-749-1921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2023-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1700214046Medicaid