Provider Demographics
NPI:1629096607
Name:CARES COMMUNITY HEALTH
Entity Type:Organization
Organization Name:CARES COMMUNITY HEALTH
Other - Org Name:ONE COMMUNITY HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-914-6332
Mailing Address - Street 1:1500 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5216
Mailing Address - Country:US
Mailing Address - Phone:916-914-6332
Mailing Address - Fax:916-325-1986
Practice Address - Street 1:1500 21ST ST BLDG B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5216
Practice Address - Country:US
Practice Address - Phone:916-914-6256
Practice Address - Fax:916-325-1986
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARES COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA434920Medicaid
CA434920Medicaid