Sutter Central Valley Hospitals

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

HSP37596 Issued in CA

Legal business name

SUTTER CENTRAL VALLEY HOSPITALS

Practice address

1800 Coffee Rd
Suite 110
Modesto, CA 95355-2705

Phone

(209) 572-7132

Fax

(209) 572-7077

NPI assigned

Jun 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James Breshears, PHARMD

Title

Director of Pharmacy

Phone

(209) 569-7352

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MEMORIAL MEDICAL CENTER OUTPATIENT PHARM Doing business as

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Sutter Central Valley Hospitals

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1629059746

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1043246747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COFFEE RD",
            "address_2": "SUITE 110",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552705",
            "telephone_number": "209-572-7132",
            "fax_number": "209-572-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COFFEE RD",
            "address_2": "SUITE 110",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552705",
            "telephone_number": "209-572-7132",
            "fax_number": "209-572-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER CENTRAL VALLEY HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "BRESHEARS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "209-569-7352",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "CA",
            "license": "HSP37596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0538009",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHB375960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIAL MEDICAL CENTER OUTPATIENT PHARM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rajesh Supra
• Surgical Associates Inc
• Surjit Chahal DDS, Inc
• Susan Ways PHD MD Inc.
• Kristy Ann Sutherland, RN
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals
• Sutter Central Valley Hospitals

• Institutional Pharmacy in Modesto, CA
• Providers in Modesto, CA by specialty
• Institutional Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.