Provider Demographics
NPI:1366649857
Name:SIMI VALLEY HOSPITAL PHARMACY
Entity type:Organization
Organization Name:SIMI VALLEY HOSPITAL PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:B
Authorized Official - Last Name:DEAMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:805-955-6342
Mailing Address - Street 1:2975 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1201
Mailing Address - Country:US
Mailing Address - Phone:805-955-6340
Mailing Address - Fax:805-955-6344
Practice Address - Street 1:2975 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1201
Practice Address - Country:US
Practice Address - Phone:805-955-6340
Practice Address - Fax:805-955-6344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHSP32771282E00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered282E00000XHospitalsLong Term Care Hospital
Not Answered282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHB327710OtherMEDI-CAL PROVIDER NUMBER