NPIMap

Organization Active NPI

St. John's Community Health

  • Community/Retail Pharmacy
  • San Bernardino, CA
National Provider Identifier
1811794613
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ST. JOHN'S COMMUNITY HEALTH
Practice address
1500 N Waterman Ave
San Bernardino, CA 92404-5111
Phone
(213) 226-7396
Fax
(323) 541-1445
NPI assigned
Feb 27, 2025
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Peter Tawfik
Title
Chief Pharmacy Officer
Phone
(615) 957-8115

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1500 N Waterman Ave
San Bernardino, CA 92404-5111

Mailing address

808 W 58TH St
Los Angeles, CA 90037-3632
Phone (213) 226-7396

Other practice location 1

82025 US Highway 111
Indio, CA 92201-5686
Phone (213) 226-7396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241227002943 CA Part B Supplier - Pharmacy 2961482690 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Bernardino, CA; Los Angeles, CA; Compton, CA; Indio, CA
O20250814001085 CA DME Supplier - Pharmacy 2961482690 Practice locations: San Bernardino, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
St John's Community Health1500 N Waterman Ave, San Bernardino, CA 92404(909) 898-7301 Immunosuppressive Drugs|Nebulizer Drugs Accepts assignmentParticipating since Dec 13, 2005

National Provider Directory

National Provider Directory
Tax ID family
St Johns Community Health35 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

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1811794613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "213-226-7396",
            "fax_number": "323-541-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045111",
            "telephone_number": "213-226-7396",
            "fax_number": "323-541-1445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82025 US Highway 111",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922015686",
            "country_code": "US",
            "telephone_number": "213-226-7396",
            "fax_number": "323-541-1445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. JOHN'S COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "TAWFIK",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "615-957-8115"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.