Healthcare Provider Details

I. General information

NPI: 1700672011
Provider Name (Legal Business Name): BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43322 GINGHAM AVE
LANCASTER CA
93535-4576
US

IV. Provider business mailing address

43322 GINGHAM AVE
LANCASTER CA
93535-4576
US

V. Phone/Fax

Practice location:
  • Phone: 661-874-4232
  • Fax: 888-905-5334
Mailing address:
  • Phone: 661-874-4050
  • Fax: 888-905-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARY ANTOINETTE CUMMINGS
Title or Position: CEO
Credential:
Phone: 661-466-3895