| Alpine Healthcare | |
|
912 Pine St Mount Shasta CA 96067-2143 | |
| (530) 926-5105 | |
| (530) 926-1359 |
| Full Name | Alpine Healthcare |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 912 Pine St, Mount Shasta, California |
| Authorized Official Name and Position | Chris Bayless (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5309265105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpine Healthcare 912 Pine St Mount Shasta CA 96067-2143 Ph: (530) 926-5105 | Alpine Healthcare 912 Pine St Mount Shasta CA 96067-2143 Ph: (530) 926-5105 |
| NPI Number | 1679514483 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 08/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679514483 | NPI | - | NPPES |
| EAP53856F | Other | CA | EAP |
| RHM53856F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 230000075 (California) | Primary |
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