OrganizationActive
Ivanhoe Pharmacy Inc
NPI 1689927816 · Community/Retail Pharmacy · Ivanhoe, CA
Provider details
- NPI number
- 1689927816
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Edward Derderian, Owner/Pharmacist(559) 798-1219
- License
- PHY51138 (CA)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
33060 Road 159
Ivanhoe, CA 93235-1235
Phone: (559) 798-1219
Fax: (559) 798-0975
Street-level locationGet directions
Mailing address
33060 Road 159
Ivanhoe, CA 93235-1235
Registry dates
- Enumerated
- 2012-10-25
- Last updated
- 2013-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.