Provider Demographics
NPI:1700672011
Name:BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Entity type:Organization
Organization Name:BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-466-3895
Mailing Address - Street 1:43322 GINGHAM AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535
Mailing Address - Country:US
Mailing Address - Phone:661-874-4050
Mailing Address - Fax:866-572-7851
Practice Address - Street 1:43322 GINGHAM AVE
Practice Address - Street 2:UNIT 1
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535
Practice Address - Country:US
Practice Address - Phone:661-874-4050
Practice Address - Fax:866-572-7851
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARTZ-ALTADONNA COMMUNITY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-15
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy