1306853296 NPI number — SUTTER COAST HOSPITAL

Table of content: (NPI 1306853296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306853296 NPI number — SUTTER COAST HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUTTER COAST HOSPITAL
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:
1306853296
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 E WASHINGTON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CRESCENT CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95531-8359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-464-8511
Provider Business Mailing Address Fax Number:
707-464-8886

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKINGS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97415-9730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-469-9205
Provider Business Practice Location Address Fax Number:
541-469-9204
Provider Enumeration Date:
08/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HANNA
Authorized Official First Name:
MITCH
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
707-464-8880

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 840162000 . This is a "BX REGENCE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 227691 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: CT3220 . This is a "RAILROAD RETIRE" identifier . This identifiers is of the category "OTHER".




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