1083732853 NPI number — DIGNITY HEALTH

Table of content: (NPI 1083732853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083732853 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:
Provider Other Organization Name Type Code:
6
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:
1083732853
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P. O. BOX 469009
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDDING
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
96049-6009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-225-6300
Provider Business Mailing Address Fax Number:
530-225-7278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2550 SISTER MARY COLUMBA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-4327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-529-8000
Provider Business Practice Location Address Fax Number:
530-225-7278
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MIRANDA
Authorized Official First Name:
KIM
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
530-225-6121

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , with the licence number:  230000036 , 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: 230000036 , 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: LTC30042G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZR00042H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZZC5202Z . This is a "BLUE SHIELD OF CA ACUTE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 721561118 . This is a "IRS FTN NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: MTE00272F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 721561118960800002 . This is a "CHAMPUS TRICARE ACUTE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 721561118960800005 . This is a "CHAMPUS TRICARE AMBULANCE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ56412Z . This is a "BLUE SHIELD CA CARDIOLOGY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: HSP40042H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com