NPIMap

Organization Active NPI

Pih Health Good Samaritan Hospital

Doing business as Good Samaritan Total Care Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1659830776
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PIH HEALTH GOOD SAMARITAN HOSPITAL
Doing business as
Good Samaritan Total Care Pharmacy
Practice address
1245 Wilshire Blvd Ste 201
Los Angeles, CA 90017-4812
Phone
(213) 977-4111
NPI assigned
Mar 18, 2019
Last updated
Jul 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Susanne (Sue) R Ponce (Aka Carlson)
Title
Special Projects
Phone
(562) 698-0811

Specialties & licenses 1

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

Addresses

Primary practice location

1245 Wilshire Blvd Ste 201
Los Angeles, CA 90017-4812

Mailing address

1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Phone (213) 977-2121

Other names 2

  • Good Samaritan Total Care Pharmacy Doing business as
  • Good Samaritan Hospital Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Hospital of Good Samaritan4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1245 Wilshire Blvd
Ste 201
Los Angeles, CA 90017
Phone (213) 977-4111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1659830776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174812",
            "telephone_number": "213-977-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIH HEALTH GOOD SAMARITAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "PONCE (AKA CARLSON)",
        "authorized_official_first_name": "SUSANNE (SUE)",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SPECIAL PROJECTS",
        "authorized_official_telephone_number": "562-698-0811"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Total Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Samaritan Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.