QUEENSCARE HEALTH CENTERS NPI 1952716441

NPI Information

NPI: 1952716441
Provider Name: QUEENSCARE HEALTH CENTERS
Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

CLIA Number: 05D0944354

Address:
4618 FOUNTAIN AVE
LOS ANGELES, CA
ZIP 90029
Phone: (323) 953-7170
Get Directions

QUEENSCARE HEALTH CENTERS is a clinic pharmacy pharmacy in Los Angeles, CA. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. QUEENSCARE HEALTH CENTERS NPI is 1952716441. The provider is registered as an organization entity type.

The provider's business location address is:

4618 FOUNTAIN AVE
LOS ANGELES, CA
ZIP 90029-977
Phone: (323) 953-7170
Fax: (323) 669-2379

The provider's authorized official is Barbara B. Hines .
The authorized official title is President And Ceo and has the following contact phone number (323) 669-4305.

The CLIA number assigned to this NPI record is 05D0944354 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2014 and was last updated on 6/24/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	333600000X	Pharmacy				No
2	3336C0002X	Pharmacy	Clinic Pharmacy			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W6997D	OTHER	CALIFORNIA	MEDICARE PROVIDER NUMBER
2	55-1895	OTHER	CALIFORNIA	MEDICARE FQHC PROVIDER NUMBER
3	FHC70660F	OTHER	CALIFORNIA	MEDI-CAL FQHC PROVIDER NUMBER
4	CMM70660F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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