NPIMap

Organization Active NPI

Ridgecrest Regional Hospital

  • Community/Retail Pharmacy
  • Ridgecrest, CA
National Provider Identifier
1790811289
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
53935 Issued in CA
Legal business name
RIDGECREST REGIONAL HOSPITAL
Practice address
1109 N China Lake Blvd
Ridgecrest, CA 93555-3131
Phone
(760) 446-4141
Fax
(760) 446-4600
NPI assigned
Feb 26, 2007
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Joseph Furtado, PHARM.D.NPI 1639450661
Title
Pharmacist in Charge
Phone
(760) 446-4141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 53935 CA Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1109 N China Lake Blvd
Ridgecrest, CA 93555-3131

Mailing address

1109 N China Lake Blvd
Ridgecrest, CA 93555-3131
Phone (760) 446-4141

Other identifiers 2

IdentifierTypeStateIssuer
1790811289MedicaidCA
2162070OtherPK

Other names 1

  • Center Professional Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Ridgecrest Community11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1109 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4141

Practitioners & affiliated clinicians

Practitioners 3

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1790811289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553131",
            "telephone_number": "760-446-4141",
            "fax_number": "760-446-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553131",
            "telephone_number": "760-446-4141",
            "fax_number": "760-446-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGECREST REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "FURTADO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "760-446-4141",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "53935",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790811289",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162070",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center Professional Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.