Provider Demographics
NPI:1073265302
Name:GROSSMONT HOSPITAL CORPORATION
Entity type:Organization
Organization Name:GROSSMONT HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:SUHAIB
Authorized Official - Last Name:ZANIAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:619-740-6542
Mailing Address - Street 1:3558 RUFFIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2596
Mailing Address - Country:US
Mailing Address - Phone:858-627-5620
Mailing Address - Fax:858-627-5625
Practice Address - Street 1:3558 RUFFIN RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2596
Practice Address - Country:US
Practice Address - Phone:858-627-5620
Practice Address - Fax:858-627-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy