San Jose Pharmacy Inc
NPI 1164167896ActiveOrganization· Pharmacy· Jackson Heights, NY
Pharmacy in Jackson Heights, New York, registered in NPPES in April 2022. The authorized official on file is Kenneth Gonzalez, Co/Owner. Enrolled in Medicare as part b supplier - pharmacy.
Overview
| NPI | 1164167896 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 27, 2022 |
| Last updated in NPPES | Apr 27, 2022 |
| Certified by provider | Apr 27, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Pharmacy (NY) |
|---|
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