NPIMap

Organization Active NPI

Seventh-Day Adventists Loma Linda University Medical Center, Inc.

Doing business as Campus Pharmacy

  • Pharmacy
  • Loma Linda, CA
National Provider Identifier
1174618862
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY35986 Issued in CA
Legal business name
SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER, INC.
Doing business as
Campus Pharmacy
Practice address
11161 Anderson St
Loma Linda, CA 92354-2824
Phone
(909) 558-4566
Fax
(909) 558-4586
NPI assigned
Oct 4, 2006
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Eugene Park, PHARMD
Title
Pharmacy Supervisor
Phone
(909) 558-4566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY35986 CA Primary

Addresses

Primary practice location

11161 Anderson St
Loma Linda, CA 92354-2824

Mailing address

11161 Anderson St
Loma Linda, CA 92354-2824
Phone (909) 558-4566

Other identifiers 2

IdentifierTypeStateIssuer
05-64434OtherCANAPB
PHA359860MedicaidCA

Other names 1

  • Campus Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seventh-Day Adventists Loma Linda University Medical Center Inc35 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

Locations

11161 Anderson St
Loma Linda, CA 92354
Phone (909) 558-4566

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1174618862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11161 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542824",
            "telephone_number": "909-558-4566",
            "fax_number": "909-558-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11161 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542824",
            "telephone_number": "909-558-4566",
            "fax_number": "909-558-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "909-558-4566",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY35986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPB",
            "identifier": "05-64434",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA359860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.