Organization Active NPI

Nob Hill General Store Inc

  • Community/Retail Pharmacy
  • Hollister, CA
National Provider Identifier
1154431815
Registry record updated Jun 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY53564 Issued in CA
Legal business name
NOB HILL GENERAL STORE INC
Practice address
1700 Airline Hwy
Hollister, CA 95023-5621
Phone
(831) 637-7423
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2015

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

Authorized official

Name
Helen S Singmaster
Title
Secretary
Phone
(916) 373-6394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY53564 CA Primary

Addresses

Primary practice location

1700 Airline Hwy
Hollister, CA 95023-5621

Mailing address

500 West Capitol Ave.
West Sacramento, CA 95605-2696
Phone (916) 373-6394

Other identifiers 2

IdentifierTypeStateIssuer
0510354OtherNABP
1154431815MedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040830000881 CA Part B Supplier - Mass Immunization (Roster Biller Only) 5092780338 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hollister, CA; Redwood City, CA; Salinas, CA
O20100930007586 CA DME Supplier - PharmacyDME Supplier - Grocery Store 5092780338 Practice locations: Hollister, CA

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

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
Nob Hill #6051700 Airline Hwy, Hollister, CA 95023-5782(831) 637-7423 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications Accepts assignmentParticipating since Sep 1, 2010

National Provider Directory

National Provider Directory
Tax ID family
Nob Hill 6284 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1700 Airline Hwy
Hollister, CA 95023
Phone (831) 637-4149

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435363200000",
    "number": "1154431815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WEST CAPITOL AVE.",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052696",
            "telephone_number": "916-373-6394",
            "fax_number": "916-372-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 AIRLINE HWY",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235621",
            "telephone_number": "831-637-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOB HILL GENERAL STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-06-27",
        "status": "A",
        "authorized_official_last_name": "SINGMASTER",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "916-373-6394"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY53564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0510354",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154431815",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.