NPIMap

Organization Active NPI

Emanate Health Medical Center

Doing business as Emanate Health Inter-Community Hospital

  • General Acute Care Hospital
  • Covina, CA
National Provider Identifier
1669507620
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HSP43961 Issued in CA
Legal business name
EMANATE HEALTH MEDICAL CENTER
Doing business as
Emanate Health Inter-Community Hospital
Practice address
210 W San Bernardino Rd
Covina, CA 91723-1515
Phone
(626) 915-6273
Fax
(626) 859-5887
NPI assigned
Feb 22, 2007
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EMANATE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Roger Sharma
Title
Executive VP/Cfo
Phone
(626) 938-7595

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X HSP43961 CA Primary
General Acute Care Hospital 282N00000X
Specialist 174400000X

Addresses

Primary practice location

210 W San Bernardino Rd
Covina, CA 91723-1515

Mailing address

210 W San Bernardino Rd
P.O. Box 6108
Covina, CA 91723-1515
Phone (626) 915-6273

Other identifiers 1

IdentifierTypeStateIssuer
ZZT40382GMedicaidCA

Other names 3

  • Emanate Health Inter-Community Hospital Doing business as
  • CITRUS VALLEY MEDICAL CENTER INC Former legal business name
  • Inter-Community Campus Pharmacy Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Queen of the Vly Pul FN4 organizations share this tax ID, including this one
Part of
Citrus Valley Health Partners

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1669507620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "address_2": "P.O. BOX 6108",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-915-6273",
            "fax_number": "626-859-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-915-6273",
            "fax_number": "626-859-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANATE HEALTH MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMANATE HEALTH",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "626-938-7595"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "HSP43961",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40382G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emanate Health Inter-Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CITRUS VALLEY MEDICAL CENTER INC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Inter-Community Campus Pharmacy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.