Shingletown Medical Center | |
31292 Alpine Meadows Rd Shingletown CA 96088-9462 | |
(530) 474-3390 | |
(530) 474-4899 |
Full Name | Shingletown Medical Center |
---|---|
Speciality | Clinic/Center |
Location | 31292 Alpine Meadows Rd, Shingletown, California |
Authorized Official Name and Position | Tami Fraser (CEO) |
Authorized Official Contact | 5304743390 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Shingletown Medical Center 31292 Alpine Meadows Rd Shingletown CA 96088-9462 Ph: (530) 474-3390 | Shingletown Medical Center 31292 Alpine Meadows Rd Shingletown CA 96088-9462 Ph: (530) 474-3390 |
NPI Number | 1750387072 |
---|---|
Provider Enumeration Date | 06/22/2005 |
Last Update Date | 06/22/2021 |
Medicare PECOS PAC ID | 5294720736 |
---|---|
Medicare Enrollment ID | O20040415000682 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750387072 | NPI | - | NPPES |
ZZZ30035Z | Other | CA | BLUE SHIELD |
FHC03870F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 230000091 (California) | Primary |