Provider Demographics
NPI:1376608794
Name:SUTTER MEDICAL CENTER SACRAMENTO
Entity Type:Organization
Organization Name:SUTTER MEDICAL CENTER SACRAMENTO
Other - Org Name:SUTTER MEMORIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST DIR AND CLNC COORD
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:916-733-1823
Mailing Address - Street 1:5151 F ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3223
Mailing Address - Country:US
Mailing Address - Phone:916-733-1815
Mailing Address - Fax:916-451-2714
Practice Address - Street 1:5151 F ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3223
Practice Address - Country:US
Practice Address - Phone:916-733-1815
Practice Address - Fax:916-451-2714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436673336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0551639OtherNCPDP PROVIDER IDENTIFICATION NUMBER