Healthcare Provider Details

I. General information

NPI: 1902263452
Provider Name (Legal Business Name): EXTENDED CARE SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E BIDWELL ST SUITE 2-366
FOLSOM CA
95630-3315
US

IV. Provider business mailing address

705 E BIDWELL ST SUITE 2-366
FOLSOM CA
95630-3315
US

V. Phone/Fax

Practice location:
  • Phone: 717-317-7535
  • Fax: 916-318-6950
Mailing address:
  • Phone: 717-317-7535
  • Fax: 916-318-6950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number13886
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95002266
License Number StateCA

VIII. Authorized Official

Name: WILLIAM F KRAMER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 717-364-0954