Healthcare Provider Details

I. General information

NPI: 1912318593
Provider Name (Legal Business Name): ST THOMAS EMERGENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

936 W MAIN ST
MERCED CA
95340-4519
US

IV. Provider business mailing address

1208 PASEO VERDE DR
MERCED CA
95348-1841
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-5200
  • Fax: 209-383-5700
Mailing address:
  • Phone: 209-383-5213
  • Fax: 209-383-5700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDY HAAR
Title or Position: CEO
Credential: FNP
Phone: 209-383-5200