NPIMap

Organization Active NPI

Sutter Health Sacramento Sierra Region

  • Long Term Care Pharmacy
  • Sacramento, CA
National Provider Identifier
1295893121
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHY42089 Issued in CA
Legal business name
SUTTER HEALTH SACRAMENTO SIERRA REGION
Practice address
2800 L St
Suite 450
Sacramento, CA 95816-5616
Phone
(916) 454-6744
Fax
(916) 454-6745
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Carl R. Red, R.PH.NPI 1356329197
Title
Pharmacist in Charge
Phone
(916) 454-6744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PHY42089 CA Primary

Addresses

Primary practice location

2800 L St
Suite 450
Sacramento, CA 95816-5616

Mailing address

2800 L St
Suite 450
Sacramento, CA 95816-5616
Phone (916) 454-6744

Other identifiers 3

IdentifierTypeStateIssuer
0546993OtherNCPDP NUMBER
PHY42089OtherCAPHARMACY LICENSE NUMBER
PHA420890MedicaidCA

Other names 1

  • Sutter Midtown Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sutter Immediate Care27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

2800 L St
Ste 450
Sacramento, CA 95816
Phone (916) 454-6744

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1295893121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 L ST",
            "address_2": "SUITE 450",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-454-6744",
            "fax_number": "916-454-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST",
            "address_2": "SUITE 450",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-454-6744",
            "fax_number": "916-454-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER HEALTH SACRAMENTO SIERRA REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "RED",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "916-454-6744",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY42089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "0546993",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE NUMBER",
            "identifier": "PHY42089",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA420890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Midtown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 7, 2023; 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.