Willow Creek - Six Rivers Medical Center | |
850 State Hwy 96 Willow Creek CA 95573 | |
(530) 629-3777 | |
(530) 629-2866 |
Full Name | Willow Creek - Six Rivers Medical Center |
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Speciality | Clinic/Center |
Location | 850 State Hwy 96, Willow Creek, California |
Authorized Official Name and Position | Douglas Allen Shaw (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7078227220 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Willow Creek - Six Rivers Medical Center P.o. Box 4388 Arcata CA 95518-4388 Ph: (707) 822-7220 | Willow Creek - Six Rivers Medical Center 850 State Hwy 96 Willow Creek CA 95573 Ph: (530) 629-3777 |
NPI Number | 1376570473 |
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Provider Enumeration Date | 06/26/2006 |
Last Update Date | 09/20/2019 |
Medicare PECOS PAC ID | 7416000690 |
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Medicare Enrollment ID | O20090805000678 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376570473 | NPI | - | NPPES |
55-3980 | Other | CA | BLUE CROSS PROVIDER # |
RHM10028F | Medicaid | CA | |
ZZZ33943Z | Other | CA | BLUE SHIELD PROVIDER # |
HAP10028F | Other | CA | FAMILY PACT PROVIDER # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Willow Creek Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38883 Hwy 299, Willow Creek, CA 95573 Phone: 530-629-3111 Fax: 530-629-3122 |