1801000799 NPI number — UCSB STUDENT HEALTH SERVICE PHARMACY

Table of content: (NPI 1801000799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801000799 NPI number — UCSB STUDENT HEALTH SERVICE PHARMACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UCSB STUDENT HEALTH SERVICE PHARMACY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801000799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UCSB STUDENT HEALTH SERVICE PHARMACY
Provider Second Line Business Mailing Address:
BLDG 588 UCSB, M/C 7002
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93106-7002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-893-2116
Provider Business Mailing Address Fax Number:
805-893-2736

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UCSB STUDENT HEALTH SERVICE PHARMACY
Provider Second Line Business Practice Location Address:
BLDG 588 UCSB, MC 7002
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93106-7002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-893-2116
Provider Business Practice Location Address Fax Number:
805-893-2736
Provider Enumeration Date:
05/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BELL
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
O
Authorized Official Title or Position:
PHARMACY MANAGER
Authorized Official Telephone Number:
805-893-2116

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  PHE46043 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PHE 46043 . This is a "CA STATE BOARD OF PHARMACY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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