Provider Demographics
NPI:1699743641
Name:COUNTY OF SANTA BARBARA COMMUNITY HEALTH CLINIC PHARMACY
Entity type:Organization
Organization Name:COUNTY OF SANTA BARBARA COMMUNITY HEALTH CLINIC PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DEPUTY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:805-681-5252
Mailing Address - Street 1:300 N SAN ANTONIO RD
Mailing Address - Street 2:BUILDING #4 LEVEL 2
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1316
Mailing Address - Country:US
Mailing Address - Phone:805-681-5300
Mailing Address - Fax:805-681-5430
Practice Address - Street 1:300 N SAN ANTONIO ROAD
Practice Address - Street 2:BUILDING #4 LEVEL 2
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1316
Practice Address - Country:US
Practice Address - Phone:805-681-5300
Practice Address - Fax:805-681-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46872183500000X
CA54671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0561022OtherNCDPD
CAPHA463810Medicaid
CAPHE 46381OtherSTATE LICENSE
CAPHE 46381OtherSTATE LICENSE
CAPHE 46381OtherSTATE LICENSE