NPIMap

Organization Active NPI

Loma Linda University Medical Center

  • Community/Retail Pharmacy
  • San Bernardino, CA
National Provider Identifier
1124480017
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
54334 Issued in CA
Legal business name
LOMA LINDA UNIVERSITY MEDICAL CENTER
Practice address
125 E Club Center Dr Ste 1500
San Bernardino, CA 92408-4107
Phone
(909) 651-4705
Fax
(909) 651-4703
NPI assigned
Mar 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Authorized official

Name
Anthony Alan Hilliard
Title
Ceo
Phone
(909) 558-5188

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 54334 CA Primary

Addresses

Primary practice location

125 E Club Center Dr Ste 1500
San Bernardino, CA 92408-4107

Mailing address

125 E Club Center Dr Ste 1500
San Bernardino, CA 92408-4107
Phone (909) 651-4705

Other identifiers 1

IdentifierTypeStateIssuer
2159118OtherPK

Other names 1

  • Loma Linda University Home Delivery Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170908001217 CA DME Supplier - Pharmacy 8325099138 Practice locations: San Bernardino, CA

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Loma Linda Emerg Med GR35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

125 E Club Center Dr
Ste 1500
San Bernardino, CA 92408
Phone (909) 558-4497

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Kara HealthAnaheim, CA, CCN A01786 Hospice 5% Or Greater Indirect Ownership Interest (51%) Feb 17, 2026

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1124480017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E CLUB CENTER DR STE 1500",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084107",
            "telephone_number": "909-651-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E CLUB CENTER DR STE 1500",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084107",
            "telephone_number": "909-651-4705",
            "fax_number": "909-651-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA UNIVERSITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "HILLIARD",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-558-5188"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loma Linda University Home Delivery Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Loma Linda University Home Delivery Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.