Healthcare Provider Details

I. General information

NPI: 1609881499
Provider Name (Legal Business Name): SUTTER COAST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 E WASHINGTON BLVD STE 14&15
CRESCENT CITY CA
95531-8343
US

IV. Provider business mailing address

800 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-8741
  • Fax: 707-464-3742
Mailing address:
  • Phone: 707-464-8511
  • Fax: 707-464-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010000265
License Number StateCA

VIII. Authorized Official

Name: MITCH HANNA
Title or Position: CEO
Credential:
Phone: 707-464-8880