NPIMap

Organization Active NPI

Sonora Community Hospital

  • Community/Retail Pharmacy
  • Sonora, CA
National Provider Identifier
1609836634
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY44265 Issued in CA
Legal business name
SONORA COMMUNITY HOSPITAL
Practice address
900 Greenley Rd Ste 912
Ste 912
Sonora, CA 95370-5287
Phone
(209) 536-3700
Fax
(209) 536-3511
NPI assigned
Mar 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Authorized official

Name
Denise Button
Title
Pharmacy Analyst
Phone
(209) 536-3697

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY44265 CA Primary

Addresses

Primary practice location

900 Greenley Rd Ste 912
Ste 912
Sonora, CA 95370-5287

Mailing address

900 Greenley Rd Ste 912
Ste 912
Sonora, CA 95370-5287
Phone (209) 536-3700

Other identifiers 1

IdentifierTypeStateIssuer
1609836634MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930011277 CA DME Supplier - Pharmacy 4284538505 Practice locations: Sonora, CA

Other NPIs with the same Medicare PAC ID 9

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
Adventist Health Sonora900 Greenley Rd, Sonora, CA 95370-5287(209) 536-3704 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since May 25, 1994

National Provider Directory

National Provider Directory
Tax ID family
Sonora Community Hospit7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 138

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

View all 138

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": "1521504000000",
    "number": "1609836634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 GREENLEY RD STE 912",
            "address_2": "STE 912",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705287",
            "telephone_number": "209-536-3700",
            "fax_number": "209-536-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 GREENLEY RD STE 912",
            "address_2": "STE 912",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705287",
            "telephone_number": "209-536-3700",
            "fax_number": "209-536-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORA COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "BUTTON",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PHARMACY ANALYST",
        "authorized_official_telephone_number": "209-536-3697"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY44265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609836634",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.