Healthcare Provider Details

I. General information

NPI: 1588385454
Provider Name (Legal Business Name): ENLOE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 COHASSET RD
CHICO CA
95926-2241
US

IV. Provider business mailing address

1531 ESPLANADE
CHICO CA
95926-3310
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-7300
  • Fax:
Mailing address:
  • Phone: 530-332-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE VENARD
Title or Position: PFS DIRECTOR
Credential:
Phone: 530-332-6331