Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 2357 W Tahoe, Caruthers, California |
Authorized Official Name and Position | Charles W. Smith (COO) |
Authorized Official Contact | 5598674416 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 543 Riverdale CA 93656-0543 Ph: (559) 867-4416 | 2357 W Tahoe Caruthers CA 93609 Ph: (559) 864-5200 |
NPI Number | 1427159649 |
---|---|
Provider Enumeration Date | 09/26/2006 |
Last Update Date | 10/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427159649 | NPI | - | NPPES |
RHM08906 | Medicaid | CA | |
HAP08906F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |