Healthcare Provider Details

I. General information

NPI: 1225075971
Provider Name (Legal Business Name): SHARP CORONADO HOSPITAL AND HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PROSPECT PL
CORONADO CA
92118-1943
US

IV. Provider business mailing address

8695 SPECTRUM CENTER BLVD
SAN DIEGO CA
92123-1489
US

V. Phone/Fax

Practice location:
  • Phone: 619-522-3700
  • Fax:
Mailing address:
  • Phone: 858-499-3025
  • Fax: 858-499-3020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberHSP22448
License Number StateCA

VIII. Authorized Official

Name: SUSAN STONE
Title or Position: CEO
Credential:
Phone: 619-522-3700