Healthcare Provider Details

I. General information

NPI: 1316143043
Provider Name (Legal Business Name): EASTERN PLUMAS HEALTH CARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 HOT SPRINGS RD
GREENVILLE CA
95947
US

IV. Provider business mailing address

500 1ST AVE
PORTOLA CA
96122-9406
US

V. Phone/Fax

Practice location:
  • Phone: 530-832-6564
  • Fax: 530-832-4494
Mailing address:
  • Phone: 530-832-6500
  • Fax: 530-832-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: APREL MARTIN
Title or Position: BUSINESS SERVICES MANAGER
Credential:
Phone: 530-832-6569