MEDICARE: FEATHER RIVER TRIBAL HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center	230000003	CA
2	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BCP70041G	OTHER	CA	BREAST CANCER PROGRAM
2	HAP70041G	OTHER	CA	FAMILY PACT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922090588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEATHER RIVER TRIBAL HEALTH, INC.

Provider Business Mailing Address
First Line	:	2145 5TH AVE
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-5870
Country	:	US
Telephone Number	:	530-534-5394
Fax Number	:	530-534-3820

Provider Business Practice Location Address
First Line	:	2145 5TH AVE
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965
Country	:	US
Telephone Number	:	530-534-5394
Fax Number	:	530-534-3820

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. MARIA HUNZEKER
Credential	:
Telephone Number	:	530-534-5394

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	08/03/2018

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