MEMORIAL MEDICAL CENTER OUTPATIENT PHARM
NPI 1043246747
Pharmacy - Institutional Pharmacy in Modesto, CA
NPI Status: Active since June 24, 2006
Contact Information
1800 COFFEE RD
SUITE 110
MODESTO, CA
ZIP 95355
Phone: (209) 572-7132
Fax: (209) 572-7077
- Organization
- Pharmacy
- Institutional Pharmacy
- CLIA Number: 05D0698026
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 06-24-2027
About MEMORIAL MEDICAL CENTER OUTPATIENT PHARM
This page provides the complete NPI Profile along with additional information for Memorial Medical Center Outpatient Pharm, a provider established in Modesto, California operating as a Pharmacy, focusing in institutional pharmacy . The healthcare provider is registered in the NPI registry with number 1043246747 assigned on June 2006. The practitioner's primary taxonomy code is 3336I0012X with license number HSP37596 (CA). The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's is doing business as Memorial Medical Center Outpatient Pharm. The authorized official of this NPI record is James Breshears Pharmd (Director Of Pharmacy)
- NPI
- 1043246747
- Provider Legal Name
- SUTTER CENTRAL VALLEY HOSPITALS
- Other Organization Name
- MEMORIAL MEDICAL CENTER OUTPATIENT PHARM
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1800 COFFEE RD SUITE 110 MODESTO, CA 95355
- Location Phone
- (209) 572-7132
- Location Fax
- (209) 572-7077
- Mailing Address
- 1800 COFFEE RD SUITE 110 MODESTO, CA 95355
- Mailing Phone
- (209) 572-7132
- Mailing Fax
- (209) 572-7077
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-24-2006
- Last Update Date
- 10-06-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Institutional Pharmacy
- Taxonomy Code
- 3336I0012X
- Type
- Suppliers
- License No.
- HSP37596
- License State
- CA
- Taxonomy Description
- A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| PHB375960 | MEDICAID (05) | CA | |
| 0538009 | OTHER (01) | NCPDP PROVIDER IDENTIFICATION NUMBER |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0698026
- Facility Type
- Hospital
- Certificate Effective Date
- June 25, 2025
- Certificate Expiration Date
- June 24, 2027
- Laboratory Director
- HARVEY CHANG
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Memorial Medical Center Outpatient Pharm on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1043246747, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043246747, enumerated as an "organization" on June 24, 2006.
The provider is located at 1800 COFFEE RD SUITE 110 MODESTO, CA 95355 and the phone number is (209) 572-7132.
Pharmacy with taxonomy code 3336I0012X and a focus in Institutional Pharmacy.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
