Provider Demographics
NPI:1760493274
Name:CHINAKAS PHARMACY INC
Entity Type:Organization
Organization Name:CHINAKAS PHARMACY INC
Other - Org Name:DAY STREET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINAKA
Authorized Official - Suffix:
Authorized Official - Credentials:BS ,PHARMD
Authorized Official - Phone:951-485-8100
Mailing Address - Street 1:23900 IRONWOOD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7151
Mailing Address - Country:US
Mailing Address - Phone:951-485-8100
Mailing Address - Fax:951-485-8811
Practice Address - Street 1:23900 IRONWOOD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7151
Practice Address - Country:US
Practice Address - Phone:951-485-8100
Practice Address - Fax:951-485-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X, 3336S0011X
CA471533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2113533OtherPK
CAPHA471530Medicaid
5560410001Medicare NSC