1871697102 NPI number — OROVILLE HOSPITAL

Table of content: (NPI 1871697102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871697102 NPI number — OROVILLE HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OROVILLE 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:
1871697102
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2767 OLIVE HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OROVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95966-6118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1611 FEATHER RIVER BLVD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95965-4548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-534-4530
Provider Business Practice Location Address Fax Number:
530-534-4575
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WENTZ
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
530-533-8550

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: BCP08585F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: RHM058585F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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