NPIMap

Organization Active NPI

Marshall Medical Center

Doing business as Marshall Medical Specialty Pharmacy

  • Community/Retail Pharmacy
  • Cameron Park, CA
National Provider Identifier
1447912191
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MARSHALL MEDICAL CENTER
Doing business as
Marshall Medical Specialty Pharmacy
Practice address
3581 Palmer Dr Ste 601
Cameron Park, CA 95682-8238
Phone
(530) 344-5423
NPI assigned
Oct 11, 2021
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MARSHALL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Mrs. Laurie Eldridge
Title
Cfo
Phone
(530) 626-2780

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

3581 Palmer Dr Ste 601
Cameron Park, CA 95682-8238

Mailing address

1100 Marshall Way
Placerville, CA 95667-6533
Phone (530) 626-2789

Other practice location 1

3581 Palmer Dr Ste 600
Cameron Park, CA 95682-8238
Phone (530) 344-5423

Other names 1

  • MARSHALL MEDICAL SPECIALTY PHARMACY Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address specialtypharmacy@marshallmedical.org Health Information Exchange (HIE) Marshall Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230120001693 CA DME Supplier - Pharmacy 7517875859 Practice locations: Cameron Park, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Marshall Medical Specialty Pharmacy3581 Palmer Dr, Cameron Park, CA 95682-8238(530) 344-5423 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Nov 28, 2005

National Provider Directory

National Provider Directory
Tax ID family
Marshall Center Primary18 organizations share this tax ID, including this one
Part of
Marshall Center Primary

Other organizations with this tax ID 17

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

View all 17

Locations

3581 Palmer Dr
Ste 600
Cameron Park, CA 95682
Phone (530) 344-5423

3581 Palmer Dr
Ste 601
Cameron Park, CA 95682
Phone (530) 344-5423

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Divide Wellness CenterGeorgetown, CA, CCN 058514 Rural health clinic Operational/Managerial Control Jun 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1447912191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MARSHALL WAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676533",
            "telephone_number": "530-626-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 PALMER DR STE 601",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828238",
            "telephone_number": "530-344-5423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3581 Palmer Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Cameron Park",
            "state": "CA",
            "postal_code": "956828238",
            "country_code": "US",
            "telephone_number": "530-344-5423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHALL MEDICAL CENTER",
        "enumeration_date": "2021-10-11",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-626-2780",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "specialtypharmacy@marshallmedical.org",
            "affiliation": "Y",
            "endpointDescription": "business email",
            "affiliationName": "Marshall Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3581 Palmer Dr Ste 601",
            "city": "Cameron Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956828238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MARSHALL MEDICAL SPECIALTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cameron Park, CA

Sources for this page

Verify at the official NPI Registry.