1942283866 NPI number — NEVADA CITY HOSPITAL

Table of content: (NPI 1942283866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942283866 NPI number — NEVADA CITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEVADA CITY 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:
1942283866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 S ASH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEVADA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64772-3223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-667-3355
Provider Business Mailing Address Fax Number:
417-448-3796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 S ASH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEVADA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-667-3355
Provider Business Practice Location Address Fax Number:
417-448-3796
Provider Enumeration Date:
11/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ANGLIN
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
417-448-3626

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 275N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NR1301X , with the licence number: 190-46 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100099780A , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26S061 . This is a "MEDICARE OSCAR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 90034015 . This is a "FACILITY BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 010419000 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01341012 . This is a "PROFESSIONAL BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 260061 . This is a "MEDICARE OSCAR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 540419009 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26U061 . This is a "MEDICARE OSCAR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: CD4556 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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