1. Home
  2. Directory
  3. California
  4. Pacoima
  5. Pharmacy
  6. NPI Profile

PACOIMA RX PHARMACY INC
NPI 1104546365
Pharmacy - Community/Retail Pharmacy in Pacoima, CA

Active since August 29, 2022
13630 VAN NUYS BLVD STE 101, PACOIMA, CA 91331(747) 227-3077(747) 227-3078 Get Directions Write a Review

NPPES record last updated: August 29, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Pacoima Rx Pharmacy Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACOIMA RX PHARMACY INC (NPI 1104546365), doing business as Pacoima Rx Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Pacoima, California and active in the NPI registry since August 2022. The organization lists Mayer Rafikalimy, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1104546365
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePACOIMA RX PHARMACY INC
Location Address13630 VAN NUYS BLVD STE 101Pacoima, CA 91331-3655
Mailing Address13630 Van Nuys Blvd Ste 101Pacoima, CA 91331-3655 · (747) 227-3077 · Fax (747) 227-3078
Phone(747) 227-3077
Fax(747) 227-3078
Organization SubpartNo
Authorized OfficialMayer RafikalimyPresident/ceo · (747) 227-3077
Enumeration DateAugust 29, 2022
NPPES CertifiedAugust 29, 2022
✔ NPI 1104546365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
Also ListedPharmacyTaxonomy 333600000X
13630 VAN NUYS BLVD STE 101, Pacoima, CA 91331
Open in Google Maps ↗

Other Names 1

Doing Business AsPacoima Rx Pharmacy

Other Identifiers 1

OtherPHY58755CA · Board Of Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Pacoima Rx Pharmacy carries, from the Medicare DMEPOS supplier directory.

Pacoima Rx Pharmacy

DMEPOS supplier · Pacoima, CAOperated by Pacoima Rx Pharmacy Inc
⋮

Does not accept Medicare assignment

Pacoima Rx Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20306675
Medicare Participant SinceApril 5, 2023
Supplier Location13630 Van Nuys Blvd Suite 101Pacoima, CA 91331
Phone(747) 227-3077
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacoima Rx Pharmacy Inc's NPI number?

The NPI number for Pacoima Rx Pharmacy Inc is 1104546365. It was assigned to this organization in the NPPES registry on August 29, 2022. The provider is doing business as Pacoima Rx Pharmacy.

Where is Pacoima Rx Pharmacy Inc located?

Pacoima Rx Pharmacy Inc is located at 13630 Van Nuys Blvd Ste 101, Pacoima, CA 91331. The listed phone number is (747) 227-3077.

What is Pacoima Rx Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Pacoima Rx Pharmacy Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Pacoima Rx Pharmacy does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Pacoima Rx Pharmacy Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 33 other insurers list Pacoima Rx Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pacoima Rx Pharmacy Inc was last updated on August 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.