Healthcare Provider Details

I. General information

NPI: 1124645924
Provider Name (Legal Business Name): COMMUNITY MEMORIAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 LOMA VISTA ROAD
VENTURA CA
93003
US

IV. Provider business mailing address

147 N BRENT ST
VENTURA CA
93003-2809
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-5011
  • Fax:
Mailing address:
  • Phone: 805-652-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: RENU BAJWA
Title or Position: MEDICATION SAFETY COORDINATOR
Credential:
Phone: 805-652-4037