1821171877 NPI number — SUTTER VISITING NURSE ASSOCIATION AND HOSPICE

Table of content: (NPI 1821171877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821171877 NPI number — SUTTER VISITING NURSE ASSOCIATION AND HOSPICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
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:
1821171877
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5099 COMMERCIAL CIR STE 208
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94520-1374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-771-0328
Provider Business Mailing Address Fax Number:
707-863-9043

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8318 FERGUSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95828-0902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-379-3200
Provider Business Practice Location Address Fax Number:
866-932-7052
Provider Enumeration Date:
10/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCPHERSON
Authorized Official First Name:
MARK
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT (CEO)
Authorized Official Telephone Number:
855-771-0328

Provider Taxonomy Codes

  • Taxonomy code: 3336H0001X , with the licence number:  45066 , 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: ZZZ02700Z . This is a "SUTTER INFUSION PHARMACY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ 098992 . This is a "SUTTER INFUSION PHARMACY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: PHA450660 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1071252 . This is a "SUTTER INFUSION PHARMACY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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