Siskiyou Hospital Inc | |
8 Commercial Street Etna CA 96027 | |
(530) 467-5393 | |
(530) 467-5355 |
Full Name | Siskiyou Hospital Inc |
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Speciality | Clinic/Center |
Location | 8 Commercial Street, Etna, California |
Authorized Official Name and Position | Jonathon C Andrus (CEO) |
Authorized Official Contact | 5308424121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Siskiyou Hospital Inc 444 Bruce Street Yreka CA 96097-3450 Ph: (530) 841-6256 | Siskiyou Hospital Inc 8 Commercial Street Etna CA 96027 Ph: (530) 467-5393 |
NPI Number | 1336330646 |
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Provider Enumeration Date | 08/05/2007 |
Last Update Date | 12/26/2019 |
Medicare PECOS PAC ID | 1254223134 |
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Medicare Enrollment ID | O20191120000955 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336330646 | NPI | - | NPPES |
RHM18517F | Medicaid | CA | |
BCP18517F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 230000035 (California) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |