NPIMap

Organization Active NPI

Grossmont Hospital Corporation

Doing business as Sharp Specialty Pharmacy Services

  • Specialty Pharmacy
  • San Diego, CA
National Provider Identifier
1932485307
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
GROSSMONT HOSPITAL CORPORATION
Doing business as
Sharp Specialty Pharmacy Services
Practice address
3558 Ruffin Rd Ste 101
San Diego, CA 92123-2596
Phone
(858) 627-5644
Fax
(858) 627-5610
NPI assigned
Oct 28, 2011
Last updated
Sep 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GROSSMONT HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X NU Primary

Addresses

Primary practice location

3558 Ruffin Rd Ste 101
San Diego, CA 92123-2596

Mailing address

3558 Ruffin Rd Ste 101
San Diego, CA 92123-2596
Phone (858) 627-5644

Other names 1

  • Sharp Specialty Pharmacy Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240207002972 CA Part B Supplier - Pharmacy 4183518137 Practice locations: San Diego, CA

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Part of
Grossmont Hospital Corp

NPI Registry JSON

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1932485307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 RUFFIN RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232596",
            "telephone_number": "858-627-5644",
            "fax_number": "858-627-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3558 RUFFIN RD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232596",
            "telephone_number": "858-627-5644",
            "fax_number": "858-627-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSMONT HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROSSMONT HOSPITAL CORPORATION",
        "enumeration_date": "2011-10-28",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "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": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharp Specialty Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharp Specialty Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.