NPIMap

Organization Active NPI

Renown Regional Medical Center

  • Clinic Pharmacy
  • Reno, NV
National Provider Identifier
1194800326
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PH00839 Issued in NV
Legal business name
RENOWN REGIONAL MEDICAL CENTER
Practice address
21 Locust St
Reno, NV 89502-1316
Phone
(775) 982-5281
Fax
(775) 982-5250
NPI assigned
Oct 26, 2006
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Adam Porath, PHARMD, BCACP, BCPS-
Title
VP, Pharmacy
Phone
(775) 982-6838

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X PH00839 NV Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

21 Locust St
Reno, NV 89502-1316

Mailing address

21 Locust St
Reno, NV 89502-1316
Phone (775) 982-5281

Other identifiers 2

IdentifierTypeStateIssuer
2056839OtherPK
2816185MedicaidNV

Other names 1

  • Renown Pharmacy - Locust Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211206001181 NV Part B Supplier - Pharmacy 9931005337 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reno, NV

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Renown Regional Medical Ctr10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1194800326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LOCUST ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021316",
            "telephone_number": "775-982-5281",
            "fax_number": "775-982-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LOCUST ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021316",
            "telephone_number": "775-982-5281",
            "fax_number": "775-982-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOWN REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "PORATH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "VP, PHARMACY",
        "authorized_official_telephone_number": "775-982-6838",
        "authorized_official_credential": "PHARMD, BCACP, BCPS-"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NV",
            "license": "PH00839",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2056839",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2816185",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renown Pharmacy - Locust",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.