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Organization Active NPI

Hazel Hawkins Memorial Hospital

Doing business as Hazel Hawkins MEM Hospital

  • Institutional Pharmacy
  • Hollister, CA
National Provider Identifier
1417314501
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
HPE39475 Issued in CA
Legal business name
HAZEL HAWKINS MEMORIAL HOSPITAL
Doing business as
Hazel Hawkins MEM Hospital
Practice address
911 Sunset Dr
Hollister, CA 95023-5606
Phone
(831) 636-2655
Fax
(831) 636-2614
NPI assigned
Jan 21, 2016
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Mrs. Mary Casillas
Title
Pharmacy Director
Phone
(831) 636-2604

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X HPE39475 CA Primary

Addresses

Primary practice location

911 Sunset Dr
Hollister, CA 95023-5606

Mailing address

911 Sunset Dr
Hollister, CA 95023-5606
Phone (831) 636-2655

Other identifiers 1

IdentifierTypeStateIssuer
2157490OtherPK

Other names 1

  • Hazel Hawkins MEM Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hazel Hawkins HSP Rad D10 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": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1417314501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 SUNSET DR",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235606",
            "telephone_number": "831-636-2655",
            "fax_number": "831-636-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 SUNSET DR",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235606",
            "telephone_number": "831-636-2655",
            "fax_number": "831-636-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZEL HAWKINS MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "CASILLAS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "831-636-2604",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "CA",
            "license": "HPE39475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157490",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazel Hawkins MEM Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hazel Hawkins MEM Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollister, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.