NPIMap

Organization Active NPI

County of Santa Clara

Doing business as Valley Health Center Bascom Pharmacy

  • Pharmacy
  • San Jose, CA
National Provider Identifier
1104904390
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHE32327 Issued in CA
Legal business name
COUNTY OF SANTA CLARA
Doing business as
Valley Health Center Bascom Pharmacy
Valley Health Center San Jose Pharmacy
Practice address
750 S Bascom Ave
San Jose, CA 95128-2603
Phone
(408) 885-2320
Fax
(408) 885-3729
NPI assigned
Nov 2, 2006
Last updated
Sep 5, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF SANTA CLARAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Paul E Lorenz
Title
Chief Executive Officer
Phone
(408) 885-4010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHE32327 CA Primary

Addresses

Primary practice location

750 S Bascom Ave
San Jose, CA 95128-2603

Mailing address

777 Turner Dr Ste 330
San Jose, CA 95128
Phone (408) 885-2300

Other identifiers 1

IdentifierTypeStateIssuer
PHB323270MedicaidCA

Other names 2

  • Valley Health Center Bascom Pharmacy Doing business as
  • Valley Health Center San Jose Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090202000601 CA Part B Supplier - Pharmacy 1254244973 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sunnyvale, CA; San Jose, CA; Gilroy, CA; Milpitas, CA; Morgan Hill, CA; Palo Alto, CA
O20190522000119 CA DME Supplier - Pharmacy 1254244973 Practice locations: San Jose, CA

Other NPIs on the same Medicare enrollment 17

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

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Valley Health Center at Bascom750 S Bascom Ave, San Jose, CA 95128-2603(408) 885-2320 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) Accepts assignmentParticipating since Oct 1, 1985

National Provider Directory

National Provider Directory
Tax ID family
Santa Clara Cnty Health177 organizations share this tax ID, including this one
Part of
Santa Clara Cnty Health

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 24

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

FacilityTypeRoleSince
Santa Clara Valley Medical CenterSan Jose, CA, CCN 050038 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 30, 2007
Santa Clara Valley Health and Hospital SystemSan Jose, CA, CCN 05T038 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Santa Clara Valley Health and Hospital SystemSan Jose, CA, CCN 05S038 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
O' Connor HospitalSan Jose, CA, CCN 555916 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2019
Santa Clara Health & Hospital SystemSan Jose, CA, CCN 551957 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Santa Clara Health & Hospital SystemMilpitas, CA, CCN 551958 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 3, 2010
Valley Health Center - SunnyvaleSunnyvale, CA, CCN 051051 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 16, 1966
Santa Clara Health & Hospital SystemSan Jose, CA, CCN 051050 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Santa Clara Valley Health and Hospice SystemSan Jose, CA, CCN 051052 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2012
Santa Clara Valley HealthcareSan Jose, CA, CCN 051128 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 7, 2007
Santa Clara Health & Hospital SystemGilroy, CA, CCN 051926 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN 051927 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Valley Health Center AlexianSan Jose, CA, CCN 551049 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 19, 2010
Aug 19, 2010
Valley Health Center at DowntownSan Jose, CA, CCN 751863 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 28, 2016
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01097 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2019
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01143 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1966
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01169 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01168 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 4, 2023
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01850 Federally qualified health center 5% Or Greater Direct Ownership Interest Dec 13, 2023
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01868 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 28, 2021
Santa Clara Health &Hospital SystemPalo Alto, CA, CCN A01946 Federally qualified health center 5% Or Greater Direct Ownership Interest Apr 16, 2024
Santa Clara Valley Health & Hospital SystemSan Jose, CA, CCN A01922 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 18, 2021
Santa Clara Valley Health & Hospital SystemMorgan Hill, CA, CCN A01912 Federally qualified health center 5% Or Greater Direct Ownership Interest Mar 18, 2024
Santa Clara Health & Hospital SystemSan Jose, CA, CCN A11032 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 22, 2025

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1104904390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 TURNER DR STE 330",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-885-2300",
            "fax_number": "408-885-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282603",
            "telephone_number": "408-885-2320",
            "fax_number": "408-885-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SANTA CLARA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SANTA CLARA",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "LORENZ",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "408-885-4010"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHE32327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHB323270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Health Center Bascom Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Center San Jose Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.