NPIMap

Organization Active NPI

Via Care Community Health Center

  • Pharmacy
  • Los Angeles, CA
National Provider Identifier
1194293282
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
VIA CARE COMMUNITY HEALTH CENTER
Practice address
615 S Atlantic Blvd
Los Angeles, CA 90022-3211
Phone
(323) 268-9191
NPI assigned
Nov 6, 2018
Organization subpart
Yes
Parent organization
VIA CARE COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
Vanessa Fuentes
Title
Director of Revenue Cycle Managemen
Phone
(213) 268-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

615 S Atlantic Blvd
Los Angeles, CA 90022-3211

Mailing address

3601 E 1St St
Los Angeles, CA 90063-2325
Phone (323) 268-9191

Other names 1

  • Via Care Community Health Center-Pharmacy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200716001221 CA Part B Supplier - Pharmacy 1052550365 Practice locations: Los Angeles, CA

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Via Care Community Health Center-Elac Student Health Center25 organizations share this tax ID, including this one
Part of
Via Care Community Health Center-Elac Student Health Center

Other organizations with this tax ID 24

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

View all 24

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Via Care Community Health CenterLos Angeles, CA, CCN 751121 Federally qualified health center Operational/Managerial Control (100%) Oct 12, 2010
Via Care Community Health CenterLos Angeles, CA, CCN 921917 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 21, 2015
Via Care Community Health CenterLos Angeles, CA, CCN 921919 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 21, 2015

Owned or controlled facilities with NPI records 3

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

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1194293282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 E 1ST ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632325",
            "telephone_number": "323-268-9191",
            "fax_number": "323-268-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223211",
            "telephone_number": "323-268-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIA CARE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIA CARE COMMUNITY HEALTH CENTER",
        "enumeration_date": "2018-11-06",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MANAGEMEN",
        "authorized_official_telephone_number": "213-268-9191"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Via Care Community Health Center-Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.