NPIMap

Organization Active NPI

County of San Diego

  • Long Term Care Pharmacy
  • Santee, CA
National Provider Identifier
1316952914
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
34002 Issued in CA
Legal business name
COUNTY OF SAN DIEGO
Practice address
655 Park Center Dr
Santee, CA 92071-6957
Phone
(619) 596-6340
Fax
(619) 596-6341
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
Gwenmarie Hilleary
Title
Administrator
Phone
(619) 596-5500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X 34002 CA Primary

Addresses

Primary practice location

655 Park Center Dr
Santee, CA 92071-6957

Mailing address

655 Park Center Dr
Santee, CA 92071-6957
Phone (619) 596-6340

Other identifiers 2

IdentifierTypeStateIssuer
2114082OtherPK
ZZT05008FMedicaidCA

Other names 1

  • EDGEMOOR HOSPITAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edgemoor Geriatric Hospital101 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1316952914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 PARK CENTER DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920716957",
            "telephone_number": "619-596-6340",
            "fax_number": "619-596-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 PARK CENTER DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920716957",
            "telephone_number": "619-596-6340",
            "fax_number": "619-596-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "HILLEARY",
        "authorized_official_first_name": "GWENMARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-596-5500"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "34002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2114082",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05008F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDGEMOOR HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.