Provider Demographics
NPI:1801000799
Name:UCSB STUDENT HEALTH SERVICE PHARMACY
Entity type:Organization
Organization Name:UCSB STUDENT HEALTH SERVICE PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:O
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:805-893-2116
Mailing Address - Street 1:UCSB STUDENT HEALTH SERVICE PHARMACY
Mailing Address - Street 2:BLDG 588 UCSB, M/C 7002
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-7002
Mailing Address - Country:US
Mailing Address - Phone:805-893-2116
Mailing Address - Fax:805-893-2736
Practice Address - Street 1:UCSB STUDENT HEALTH SERVICE PHARMACY
Practice Address - Street 2:BLDG 588 UCSB, MC 7002
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-7002
Practice Address - Country:US
Practice Address - Phone:805-893-2116
Practice Address - Fax:805-893-2736
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UC REGENTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-09
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHE46043261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHE 46043OtherCA STATE BOARD OF PHARMACY