NPIMap

Organization Active NPI

Children'S Hospital Central California Campus Pharmacy

  • Pharmacy
  • Madera, CA
National Provider Identifier
1558321307
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY437930 Issued in CA
Legal business name
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA CAMPUS PHARMACY
Practice address
41169 Goodwin Way
Mail Stop MB09
Madera, CA 93638-8766
Phone
(559) 353-6300
Fax
(559) 353-6308
NPI assigned
Mar 24, 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
Dr. Gregory Alan Inouye, PHARM. D.
Title
Pharmacist in Charge
Phone
(559) 353-6302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY437930 CA Primary

Addresses

Primary practice location

41169 Goodwin Way
Mail Stop MB09
Madera, CA 93638-8766

Mailing address

41169 Goodwin Way
Mail Stop MB09
Madera, CA 93638-8766
Phone (559) 353-6300

Other identifiers 2

IdentifierTypeStateIssuer
0537639OtherNABP #
PHY437930MedicaidCA

Other names 1

  • Valley Children's Campus Pharmacy Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Children'S Hospital Central California11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

41169 Goodwin Way
Stop MB9
Madera, CA 93636
Phone (559) 353-6300

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1558321307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41169 GOODWIN WAY",
            "address_2": "MAIL STOP MB09",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936388766",
            "telephone_number": "559-353-6300",
            "fax_number": "559-353-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41169 GOODWIN WAY",
            "address_2": "MAIL STOP MB09",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936388766",
            "telephone_number": "559-353-6300",
            "fax_number": "559-353-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL CENTRAL CALIFORNIA CAMPUS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "INOUYE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "559-353-6302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY437930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "0537639",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY437930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Children's Campus Pharmacy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Madera, 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.