NPIMap

Organization Active NPI

Medmark Treatment Centers - Sacramento, Inc.

  • Methadone Clinic
  • Sacramento, CA
National Provider Identifier
1255419172
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
34-09 Issued in CA
Legal business name
MEDMARK TREATMENT CENTERS - SACRAMENTO, INC.
Practice address
7240 E Southgate Dr
Suites B, E, G
Sacramento, CA 95823-2627
Phone
(916) 391-4293
Fax
(916) 391-4247
NPI assigned
Nov 1, 2006
Organization subpart
Yes
Parent organization
MEDMARK SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 34-09 CA Primary

Addresses

Primary practice location

7240 E Southgate Dr
Suites B, E, G
Sacramento, CA 95823-2627

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other identifiers 2

IdentifierTypeStateIssuer
9390237OtherCAMEDICAL
34-09OtherCAOTP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opioid treatment program
Medicare-enrolled since Mar 12, 2026

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200407002793 CA Part B Supplier - Opioid Treatment Program (Otp) 2961831201 Practice locations: Sacramento, CA

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2029362Medmark Treatment Centers - Sacramento, Inc.7240 E Southgate Dr, Ste G, Sacramento, CA 95823Certificate of waiverSep 6, 2027

National Provider Directory

National Provider Directory
Part of
Medmark Services Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7240 E Southgate Dr
Ste G
Sacramento, CA 95823
Phone (916) 330-3747

7240 E Southgate Dr
Ste B
Sacramento, CA 95823
Phone (916) 391-4293

Practitioners & affiliated clinicians

Practitioners 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1255419172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-379-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 E SOUTHGATE DR",
            "address_2": "SUITES B, E, G",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232627",
            "telephone_number": "916-391-4293",
            "fax_number": "916-391-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDMARK TREATMENT CENTERS - SACRAMENTO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDMARK SERVICES",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "34-09",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "9390237",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTP LICENSE",
            "identifier": "34-09",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.