NPIMap

Organization Active NPI

Sutter Bay Hospitals

Doing business as Sutter East Bay Advanced Care Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Oakland, CA
National Provider Identifier
1699281501
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SUTTER BAY HOSPITALS
Doing business as
Sutter East Bay Advanced Care Outpatient Pharmacy
Practice address
3100 Summit St
Oakland, CA 94609-3412
Phone
(510) 869-8451
Fax
(510) 869-8458
NPI assigned
Dec 15, 2017
Last updated
Oct 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SUTTER BAY HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Ashley Hubbard
Title
Access Manager
Phone
(916) 297-9877

Specialties & licenses 1

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

Addresses

Primary practice location

3100 Summit St
Oakland, CA 94609-3412

Mailing address

3100 Summit St
Oakland, CA 94609-3412
Phone (510) 869-8451

Other names 1

  • SUTTER EAST BAY ADVANCED CARE OUTPATIENT PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221010000416 CA DME Supplier - Pharmacy 3476506528 Practice locations: Oakland, CA

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1045661East Bay Advanced Care3100 Summit Street 2ND Floor, Oakland, CA 94609Provider-performed microscopySep 19, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Sutter Health3100 Summit St, Oakland, CA 94609-3412(510) 869-8451 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 2010

National Provider Directory

National Provider Directory
Tax ID family
Childrens Hosp Pharmacy62 organizations share this tax ID, including this one
Part of
Childrens Hosp Pharmacy

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3100 Summit St
Ste 2447A
Oakland, CA 94609
Phone (510) 869-8451

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sutter Lakeside HospitalLakeport, CA, CCN 051329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2010
California Pacific Medical Center - Davies CampusSan Francisco, CA, CCN 056245 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1699281501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-869-8451",
            "fax_number": "510-869-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-869-8451",
            "fax_number": "510-869-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER BAY HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUTTER BAY HOSPITALS",
        "enumeration_date": "2017-12-15",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "916-297-9877"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUTTER EAST BAY ADVANCED CARE OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.