| Mount Shasta Health Center | |
|
101 Old Mccloud Rd Mount Shasta CA 96067-2796 | |
| (530) 999-9040 | |
| Not Available |
| Full Name | Mount Shasta Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 Old Mccloud Rd, Mount Shasta, California |
| Authorized Official Name and Position | Brandon Watkins (CFO) |
| Authorized Official Contact | 5309999010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Shasta Health Center Po Box 277 Bieber CA 96009-0277 Ph: (530) 999-9010 | Mount Shasta Health Center 101 Old Mccloud Rd Mount Shasta CA 96067-2796 Ph: (530) 999-9040 |
| NPI Number | 1629570320 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 4284685538 |
|---|---|
| Medicare Enrollment ID | O20180531001020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629570320 | NPI | - | NPPES |
| 1629570320 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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