NPIMap

Organization Active NPI

Community Memorial Hospital

  • Pharmacist
  • Fillmore, CA
National Provider Identifier
1265529002
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25177 Issued in CA
Legal business name
COMMUNITY MEMORIAL HOSPITAL
Practice address
852 W Ventura St
Fillmore, CA 93015-1837
Phone
(805) 524-9461
Fax
(805) 524-9451
NPI assigned
Oct 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dave Glyer
Title
Cfo
Phone
(805) 652-5003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25177 CA Primary

Addresses

Primary practice location

852 W Ventura St
Fillmore, CA 93015-1837

Mailing address

852 W Ventura St
Fillmore, CA 93015-1837
Phone (805) 524-9461

Other identifiers 1

IdentifierTypeStateIssuer
PHA 438010MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Community Memorial HLTH22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

852 W Ventura St
Fillmore, CA 93015
Phone (805) 524-2672

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265529002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 W VENTURA ST",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151837",
            "telephone_number": "805-524-9461",
            "fax_number": "805-524-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 W VENTURA ST",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151837",
            "telephone_number": "805-524-9461",
            "fax_number": "805-524-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLYER",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-652-5003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "25177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA 438010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fillmore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.