NPIMap

Organization Active NPI

Providence Health System Southern California Dba LCM Subacute Care Ctr

  • Rehabilitation Hospital Unit
  • Torrance, CA
National Provider Identifier
1144203142
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
47225 Issued in CA
Legal business name
PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA DBA LCM SUBACUTE CARE CTR
Practice address
3620 Lomita Blvd
Torrance, CA 90505-3938
Phone
(310) 791-4511
Fax
(310) 791-4512
NPI assigned
Nov 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Roger Greenham, PHARM.D.
Title
Pharmacist in Charge
Phone
(310) 791-4511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 47225 CA Primary

Addresses

Primary practice location

3620 Lomita Blvd
Torrance, CA 90505-3938

Mailing address

3620 Lomita Blvd
Torrance, CA 90505-3938
Phone (310) 791-4511

Other identifiers 1

IdentifierTypeStateIssuer
PHB377200MedicaidCA

Other names 1

  • Bay Harbor Rehab. Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Little Company of Mary - San Pedro8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144203142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 LOMITA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053938",
            "telephone_number": "310-791-4511",
            "fax_number": "310-791-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 LOMITA BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053938",
            "telephone_number": "310-791-4511",
            "fax_number": "310-791-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA DBA LCM SUBACUTE CARE CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREENHAM",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "310-791-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": "47225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHB377200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Harbor Rehab. Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.