Provider Demographics
NPI:1467672667
Name:HUNTINGTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HUNTINGTON MEMORIAL HOSPITAL
Other - Org Name:HUNTINGTON MEMORIAL HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RALPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-397-5555
Mailing Address - Street 1:100 W. CALIFORNIA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-7013
Mailing Address - Country:US
Mailing Address - Phone:626-397-5176
Mailing Address - Fax:626-397-2945
Practice Address - Street 1:100 W CALIFORNIA BLVD
Practice Address - Street 2:PHARMACY
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3010
Practice Address - Country:US
Practice Address - Phone:626-397-5176
Practice Address - Fax:626-397-2945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0550675OtherNABP