MCCLELLANDGMC VA PHARMACY


Address: 5342 Dudley Blvd, Mcclellan, CA 95652-1012
Phone: 9165617430

MCCLELLANDGMC VA PHARMACY (NPI# 1396842159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396842159
Entity Type Organization
Organization Name MCCLELLANDGMC VA PHARMACY
Practice Address 5342 Dudley Blvd
Mcclellan
CA 95652-1012
Practice Telephone 9165617430
Practice Fax Number 9165617475
Enumeration Date 2006-09-20
Last Update Date 2009-03-31
Authorized Official Name HECTOR MORALES (MGR PHRMCY OPERATIONS CNTR)
Authorized Official Telephone 2102218443
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332100000X Department of Veterans Affairs (VA) Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
OTHER ID NUMBER-COMMERCIAL NUMBER 0585147 01

Office Location

Street Address 5342 DUDLEY BLVD
City MCCLELLAN
State CA
Zip Code 95652-1012

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235127457 James Michael Ward Internal Medicine 5342 Dudley Blvd, Mcclellan Satellite Clinic, Mcclellan, CA 95652-1012 2005-10-11
1376182121 Elena Lanin Registered Nurse 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2019-12-26
1538702881 Tara Ann Miskovich Psychologist 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2019-10-18
1437622420 Dominique Talley Social Worker 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2019-01-02
1518489780 Jane Grabowski Audiologist 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2017-07-10
1033528963 Valerie Christian Nurse Practitioner 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2014-08-05
1760812275 Michelle Stephens Audiologist 5342 Dudley Blvd, Va Mcclellan Audiology, Mcclellan, CA 95652-1012 2013-11-19
1780950394 Kathryn Irene Daniels Internal Medicine 5342 Dudley Blvd, Mcclellan, CA 95652 2012-03-28
1104196930 Mae Ruth Doctor Nurse Practitioner 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2012-01-11
1225314503 Glenda Fe Jimenez Registered Nurse 5342 Dudley Blvd, Mcclellan, CA 95652-1012 2011-10-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548688955 Wenxia Han Registered Nurse 3401 Beech St, Bldg 949, Mcclellan, CA 95652 2014-04-02
1902231897 Marisa Salas Silva Social Worker 3401 Beech Street, Bldg 949, Mcclellan, CA 95652 2013-09-10
1295070290 Stephanie Ann Bost Dietitian, Registered 3401 Beech St., Mcclellan, CA 95652 2012-12-01
1811276025 Brian C Choi Dentist 5401 Arnold Avenue, Bldg. 88, Sacramento, CA 95652 2011-08-05
1154408391 California Shock Trauma Air Rescue Ambulance 4933 Bailey Loop, Mcclellan, CA 95652 2006-11-01
1083704530 Gerald Yang Dentist 5401 Arnold Avenue, Sacramento, CA 95652 2006-10-13
1104910652 Ann Marie Mullen Audiologist 5342 Dudley Blvd., Sacramento, CA 95652 2006-10-02
1831174556 Mark A Duckett Dentist 4101 Arnold Ave, Va /mcclellan Dental Service, Scramento, CA 95652 2005-12-15
1073596581 Jane P Addagatla Internal Medicine Va Mcclellan Opc, 5342 Dudley Blvd,bldg 98, Mcclellan Park, CA 95652 2005-11-29
1528518321 Dana Kirkwood Adkins Social Worker 3401 Beech Street, Building 949, Room #225, Mcclellan, CA 95652 2016-10-05
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Taxonomy Information

Taxonomy Code 332100000X
Grouping Suppliers
Classification Department of Veterans Affairs (VA) Pharmacy

Taxonomy Definition

Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service.
Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588612329 Martinez Vamc Department of Veterans Affairs (VA) Pharmacy 5342 Dudley Blvd Bldg 98, Mcclellan, CA 95652-1012 2006-05-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1992176192 Natural Lifestyles LLC. Department of Veterans Affairs (VA) Pharmacy 2138 W 109th St, Los Angeles, CA 90047-4609 2015-10-13
1124078308 Palo Alto Vamc Department of Veterans Affairs (VA) Pharmacy 201 9th Street, Marina, CA 93933-6039 2006-05-11
1487602025 Palo Alto Vamc Department of Veterans Affairs (VA) Pharmacy 5855 Silver Creek Valley Rd, San Jose, CA 95138-1059 2006-05-05
1396793428 West Los Angeles Vamc Department of Veterans Affairs (VA) Pharmacy 351 E Temple St, Los Angeles, CA 90012-3328 2006-05-04
1598713703 Martinez Vamc Department of Veterans Affairs (VA) Pharmacy 1601 Concord Avenue, Chico, CA 95928-9487 2006-05-04
1164685038 San Francisco Vamc Department of Veterans Affairs (VA) Pharmacy 630 Kings Ct, Ukiah, CA 95482-5003 2008-07-09
1497948442 San Francisco Vamc Department of Veterans Affairs (VA) Pharmacy 3841 Brickway Blvd, Santa Rosa, CA 95403-8226 2007-08-23
1689867632 San Francisco Vamc Department of Veterans Affairs (VA) Pharmacy 930 W Harris St, Eureka, CA 95503-3927 2007-08-23
1528016862 West Los Angeles Vamc Department of Veterans Affairs (VA) Pharmacy 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 2006-05-05
1235187683 West Los Angeles Vamc Department of Veterans Affairs (VA) Pharmacy 351 E Temple St, Los Angeles, CA 90012-3328 2006-05-05
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Competitor

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City MCCLELLAN
Zip Code 95652

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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