NPIMap

Organization Active NPI

Grossmont Hospital Corporation

Doing business as Grossmont Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • La Mesa, CA
National Provider Identifier
1801256789
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
53675 Issued in CA
Legal business name
GROSSMONT HOSPITAL CORPORATION
Doing business as
Grossmont Hospital Outpatient Pharmacy
Practice address
5555 Grossmont Center Dr # A217
La Mesa, CA 91942-3019
Phone
(619) 740-4458
Fax
(619) 740-4266
NPI assigned
Mar 4, 2016
Last updated
Feb 27, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
GROSSMONT HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Authorized official

Name
Scott Evans
Title
Ceo
Phone
(619) 740-4648

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 53675 CA Primary

Addresses

Primary practice location

5555 Grossmont Center Dr # A217
La Mesa, CA 91942-3019

Mailing address

5555 Grossmont Center Dr
A217
La Mesa, CA 91942-3019
Phone (619) 740-4458

Other identifiers 1

IdentifierTypeStateIssuer
2158472OtherPK

Other names 1

  • Grossmont Hospital Outpatient Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grossmont Hospital Corp14 organizations share this tax ID, including this one
Part of
Grossmont Hospital Corp

Other organizations with this tax ID 13

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

View all 13

Locations

5555 Grossmont Center Dr
#A217
La Mesa, CA 91942
Phone (619) 740-4451

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1801256789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "address_2": "A217",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-4458",
            "fax_number": "619-740-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR # A217",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-4458",
            "fax_number": "619-740-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSMONT HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROSSMONT HOSPITAL CORPORATION",
        "enumeration_date": "2016-03-04",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-740-4648"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "53675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158472",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grossmont Hospital Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grossmont Hospital Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

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