PORTOLA VILLAGE PHARMACY
NPI 1679666002
Pharmacy - Community/Retail Pharmacy in Portola, CA

Active since September 30, 2006
157 COMMERCIAL ST, PORTOLA, CA 96122(530) 832-4218(530) 832-1375 Get Directions Write a Review

NPPES record last updated: June 12, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Portola Village Pharmacy NPPES

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

PORTOLA VILLAGE PHARMACY (NPI 1679666002) is a healthcare organization registered as a community/retail pharmacy in Portola, California and active in the NPI registry since September 2006. The organization lists Karen M Kibble, Secretary, as its authorized official.

NPPES Registry Identity

NPI1679666002
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKIBBLE ENTERPRISES, INC.
Location Address157 COMMERCIAL STPortola, CA 96122-9606
Mailing AddressPo Box 1918Portola, CA 96122-1918 · (530) 277-2107
Fax(530) 832-1375
Organization SubpartNo
Authorized OfficialKaren M KibbleSecretary · (530) 277-2107
Enumeration DateSeptember 30, 2006
Last NPPES UpdateJune 12, 2021
NPPES CertifiedJune 12, 2021
NPI 1679666002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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
Also ListedPharmacy · Mail Order PharmacyTaxonomy 3336M0002X
157 COMMERCIAL ST, Portola, CA 96122

Other Names 1

Doing Business AsPortola Village Pharmacy

Other Identifiers 2

Other0541183Ncpdp Provider Identification Number
MedicaidPHA50236CA

Accepted Insurance

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
157 COMMERCIAL ST
PORTOLA, CA 96122
Pharmacy (Community/Retail Pharmacy)
157 COMMERCIAL ST
PORTOLA, CA 96122
Pharmacist
157 COMMERCIAL ST
PORTOLA, CA 96122

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679666002, enumerated as an "organization" on September 30, 2006.

The provider is located at 157 COMMERCIAL ST PORTOLA, CA 96122 and the phone number is (530) 832-4218.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medica, Moda Health Plan, Inc., Medicare and. Please consult your insurance carrier or call the provider to verify.