MEDICARE: EXPRESS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	3336L0003X	Long Term Care Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy	PHY43540	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1995190	OTHER		PK

General Provider Information

NPI Number	:	1821195660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS PHARMACY INC

Provider Business Mailing Address
First Line	:	752 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2247
Country	:	US
Telephone Number	:	909-398-1289
Fax Number	:	909-398-1291

Provider Business Practice Location Address
First Line	:	752 E ARROW HWY
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-2247
Country	:	US
Telephone Number	:	909-398-1289
Fax Number	:	909-398-1291

Authorized Official
Title or Position	:	PHARMACIST, OWNER
Name	:	BHUPENDRA MAVANI
Credential	:	B. PHARM
Telephone Number	:	909-398-1289

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/06/2025

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Directions to “EXPRESS PHARMACY INC ” Practice Location

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