| Shasta Cascade Health Centers- Mt Shasta | |
|
824 Pine St Mount Shasta CA 96067-2137 | |
| (530) 926-4528 | |
| Not Available |
| Full Name | Shasta Cascade Health Centers- Mt Shasta |
|---|---|
| Speciality | Clinic/Center |
| Location | 824 Pine St, Mount Shasta, California |
| Authorized Official Name and Position | Caleb J Ott (CEO) |
| Authorized Official Contact | 5309642389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shasta Cascade Health Centers- Mt Shasta Po Box 1143 Mccloud CA 96057-1143 Ph: (530) 964-2389 | Shasta Cascade Health Centers- Mt Shasta 824 Pine St Mount Shasta CA 96067-2137 Ph: (530) 926-4528 |
| NPI Number | 1033675582 |
|---|---|
| Provider Enumeration Date | 02/20/2019 |
| Last Update Date | 11/01/2024 |
| Medicare PECOS PAC ID | 3779494919 |
|---|---|
| Medicare Enrollment ID | O20190424001812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033675582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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