NPIMap

Organization Active NPI

Seventh-Day Adventists Loma Linda University Medical Center, Inc.

Doing business as Loma Linda University Faculty Pharmacy

  • Community/Retail Pharmacy
  • Loma Linda, CA
National Provider Identifier
1679518815
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER, INC.
Doing business as
Loma Linda University Faculty Pharmacy
Practice address
11370 Anderson St Ste 1000
Loma Linda, CA 92354-3450
Phone
(909) 558-2804
Fax
(909) 796-2631
NPI assigned
Jun 20, 2006
Last updated
May 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
Mr. Kerry Lynn Heinrich
Title
Chief Executive Officer
Phone
(909) 558-4308

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY47302 CA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

11370 Anderson St Ste 1000
Loma Linda, CA 92354-3450

Mailing address

11370 Anderson St Ste 1000
Loma Linda, CA 92354-3450

Other identifiers 4

IdentifierTypeStateIssuer
5617999OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHY47302OtherCACA STATE BOARD OF PHARMACY LICENSE
1679518815OtherCANPI
PHA473020MedicaidCA

Other names 1

  • Loma Linda University Faculty Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seventh-Day Adventists Loma Linda University Medical Center Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Locations

11370 Anderson St
Ste 1000
Loma Linda, CA 92354
Phone (909) 558-2804

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": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1679518815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1000",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1000",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2804",
            "fax_number": "909-796-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVENTH-DAY ADVENTISTS LOMA LINDA UNIVERSITY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "HEINRICH",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-558-4308",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY47302",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5617999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE BOARD OF PHARMACY LICENSE",
            "identifier": "PHY47302",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679518815",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA473020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loma Linda University Faculty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.