NPIMap

Organization Active NPI

State of California

Doing business as Student HLTH SRVC Csu Long BCH

  • Institutional Pharmacy
  • Long Beach, CA
National Provider Identifier
1639190606
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
PHE14217 Issued in CA
Legal business name
STATE OF CALIFORNIA
Doing business as
Student HLTH SRVC Csu Long BCH
Practice address
1250 N Bellflower Blvd
Long Beach, CA 90840-0004
Phone
(562) 985-1561
Fax
(562) 985-8404
NPI assigned
Jul 22, 2006
Last updated
Apr 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Kathy Chen
Title
Pharmacy Manager
Phone
(562) 985-1561

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X PHE14217 CA Primary

Addresses

Primary practice location

1250 N Bellflower Blvd
Long Beach, CA 90840-0004

Mailing address

1250 N Bellflower Blvd
Long Beach, CA 90840-0004
Phone (562) 985-1561

Other identifiers 2

IdentifierTypeStateIssuer
142170MedicaidCA
0534974OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • STUDENT HLTH SRVC CSU LONG BCH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
State of California Prison Industry Authority30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

1250 N Bellflower Blvd
Long Beach, CA 90840
Phone (562) 985-4111

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1639190606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N BELLFLOWER BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908400004",
            "telephone_number": "562-985-1561",
            "fax_number": "562-985-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N BELLFLOWER BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908400004",
            "telephone_number": "562-985-1561",
            "fax_number": "562-985-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "562-985-1561"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "CA",
            "license": "PHE14217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0534974",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STUDENT HLTH SRVC CSU LONG BCH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.