1518018191 NPI number — DIGNITY HEALTH

Table of content: (NPI 1518018191)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518018191 NPI number — DIGNITY HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIGNITY HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MERCY MEDICAL CENTER MERCED
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518018191
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2740 M STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERCED
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-384-6404
Provider Business Mailing Address Fax Number:
209-384-6699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 MERCY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95340-8319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-564-5000
Provider Business Practice Location Address Fax Number:
209-394-6699
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STRASSER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
209-564-5015

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  040000178 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 040000178 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZZR00444H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZZC2404Z . This is a "BSCA - DOMINCAN CAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 383738197 . This is a "FEDERAL TAX ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 383738197953400031 . This is a "TRICARE WPS" identifier . This identifiers is of the category "OTHER".
  • Identifier: HSC00444I , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: HSD00444G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 383738197953400000 . This is a "TRICARE WPS" identifier . This identifiers is of the category "OTHER".
  • Identifier: HSP40444I , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: HSC00444H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZZA2400Z . This is a "BSCA - COMMUNITY CAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: HSP40444H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: RHM19998H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZR00444I , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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