NPIMap

Organization Active NPI

Health Services Agency Outpatient Pharmacy

  • Pharmacist
  • Modesto, CA
National Provider Identifier
1821205162
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHE20138 Issued in CA
Legal business name
HEALTH SERVICES AGENCY OUTPATIENT PHARMACY
Practice address
830 Scenic Dr
Modesto, CA 95350-6131
Phone
(209) 558-5697
Fax
(209) 558-5631
NPI assigned
May 17, 2007
Last updated
Sep 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Authorized official

Name
Mary Ann Lee
Title
Hsa Director
Phone
(209) 558-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHE20138 CA Primary

Addresses

Primary practice location

830 Scenic Dr
Modesto, CA 95350-6131

Mailing address

830 Scenic Dr
Modesto, CA 95350-6131
Phone (209) 558-5697

Other identifiers 1

IdentifierTypeStateIssuer
0513730OtherCANABP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Stan Co Mentalhealth SV113 organizations share this tax ID, including this one

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

830 Scenic Dr
Modesto, CA 95350
Phone (209) 558-7000

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1821205162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-558-5697",
            "fax_number": "209-558-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-558-5697",
            "fax_number": "209-558-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SERVICES AGENCY OUTPATIENT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "HSA DIRECTOR",
        "authorized_official_telephone_number": "209-558-7000"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHE20138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "0513730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.