Lifetime Pharmacy Corp
NPI 1558512848 · Community/Retail Pharmacy · Moreno Valley, CA
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lifetime Pharmacy Corp is a Community/Retail Pharmacy organization in Moreno Valley, CA (NPI 1558512848).
Provider details
- NPI number
- 1558512848
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Ronald Vandyke, Ceo(951) 656-7171
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
17 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
23 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 23 | $33 |
Typical Medicare-allowed amounts for these services range $33–$33 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-10-04
- Last updated
- 2020-03-10
- Certified
- 2020-03-10
Frequently asked questions
- What is Lifetime Pharmacy Corp's NPI number?
- Lifetime Pharmacy Corp's National Provider Identifier (NPI) is 1558512848, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lifetime Pharmacy Corp?
- Lifetime Pharmacy Corp is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Lifetime Pharmacy Corp located?
- Lifetime Pharmacy Corp's practice location on file with NPPES is 23080 Alessandro Blvd, Moreno Valley, CA 92553-9673.
- What is Lifetime Pharmacy Corp's phone number?
- The practice phone number listed in the NPPES registry for Lifetime Pharmacy Corp is (951) 656-7171.
- Does Lifetime Pharmacy Corp accept Medicare?
- Lifetime Pharmacy Corp is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lifetime Pharmacy Corp?
- The authorized official listed on Lifetime Pharmacy Corp's NPPES record is Ronald Vandyke, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lifetime Pharmacy Corp's NPI active?
- Yes — Lifetime Pharmacy Corp's NPI (1558512848) is active in the NPPES registry as of the last update on 2020-03-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.