Healthcare Provider Details

I. General information

NPI: 1457367062
Provider Name (Legal Business Name): SUTTER COAST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

IV. Provider business mailing address

800 E WASHINGTON BLVD
CRESCENT CITY CA
95531-8359
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-8511
  • Fax: 707-464-8939
Mailing address:
  • Phone: 707-464-8511
  • Fax: 707-464-8939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberHSP00417G
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: PAIGE TERRA
Title or Position: CFO AND VP OF FINANCE SH VALLEY ARE
Credential:
Phone: 916-887-7050