Eisenhower Med Ctr Op Phcy

LBN: Eisenhower Medical Center
Eisenhower Med Ctr Op Phcy is an health care organization with primary practice located at 39000 Bob Hope Dr Kiewit Bldg, Rancho Mirage CA 92270-3221. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eisenhower Medical Center can be contacted via phone (760) 773-1219, or through Konzen, John via phone (760) 773-1219.

Contact Information

Primary practice address
39000 Bob Hope Dr Kiewit Bldg Rancho Mirage CA 92270-3221
Fax: (760) 773-1244
Website:
Authorized official contact:
Name: Konzen, John PHARM D

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY35512 California
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1699811190
LBN Legal business name Eisenhower Medical Center
DBA Doing business as Eisenhower Med Ctr Op Phcy
Authorized official Konzen, John PHARM D
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Aug 13th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699811190 NPPES
Other 0567771 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID PHY355120 NCPDP PROVIDER IDENTIFICATION NUMBER

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