NPIMap

Organization Active NPI

University of California Irvine

Doing business as Outpatient Pharmacy - UC Irvine Health

  • Specialty Pharmacy
  • Orange, CA
National Provider Identifier
1104842020
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
PHE55487 Issued in CA
Legal business name
UNIVERSITY OF CALIFORNIA IRVINE
Doing business as
Outpatient Pharmacy - UC Irvine Health
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-6604
Fax
(714) 509-2200
NPI assigned
Jul 14, 2006
Last updated
Mar 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Gina Churchill
Title
Reimbursement Director
Phone
(714) 509-6266

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Specialty Pharmacy 3336S0011X PHE55487 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

1500 S Douglass Rd #200, RT 183
Ahaneim, CA 92806-6912
Phone (714) 509-6266

Other identifiers 2

IdentifierTypeStateIssuer
2066998OtherPK
PHB22716MedicaidCA

Other names 1

  • Outpatient Pharmacy - UC Irvine Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930017237 CA DME Supplier - PharmacyDME Supplier - Hospital 5395658181 1 other NPI on this enrollment
Practice locations: Orange, CA
O20210420000679 CA Part B Supplier - Pharmacy 5395658181 3 other NPIs on this enrollment
Practice locations: Irvine, CA; Orange, CA

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
UC Irvine Medical Center - for Oc Kids42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uci HealthOrange, CA, CCN 050348 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 1974
Aug 1, 1974
University of California Irvine Medical CenterOrange, CA, CCN 05S348 Hospital 5% Or Greater Direct Ownership Interest Nov 19, 2007
University of California Irvine Medical CenterOrange, CA, CCN 05T348 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Uci Health - Los AlamitosLos Alamitos, CA, CCN 050551 Hospital Operational/Managerial Control (100%) Mar 26, 2024
Uci Health - LakewoodLakewood, CA, CCN 050581 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 26, 2024
Mar 26, 2024
Uci Family Health Center Santa AnaSanta Ana, CA, CCN 051893 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 1993
Uci Family Health Center-Santa AnaSanta Ana, CA, CCN 551965 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 20, 2004
Mar 20, 2004

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1104842020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLASS RD #200, RT 183",
            "city": "AHANEIM",
            "state": "CA",
            "postal_code": "928066912",
            "telephone_number": "714-509-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6604",
            "fax_number": "714-509-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA IRVINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "CHURCHILL",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "REIMBURSEMENT DIRECTOR",
        "authorized_official_telephone_number": "714-509-6266"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "PHE55487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2066998",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHB22716",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Outpatient Pharmacy - UC Irvine Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Outpatient Pharmacy - UC Irvine Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.