# SUTTER CENTRAL VALLEY HOSPITALS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEMORIAL MEDICAL CENTER OUTPATIENT PHARM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043246747
- **Authorized official:** JAMES BRESHEARS PHARMD (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (209) 569-7352

## Contact information

- **Practice address:** 1800 COFFEE RD, SUITE 110, MODESTO, CA 95355-2705
- **Practice address phone:** (209) 572-7132
- **Practice address fax:** (209) 572-7077
- **Mailing address:** 1800 COFFEE RD, SUITE 110, MODESTO, CA 95355-2705
- **Mailing address phone:** (209) 572-7132
- **Mailing address fax:** (209) 572-7077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | HSP37596 | CA | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 10/06/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0538009 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 05 | — | PHB375960 | — | CA |