Healthcare Provider Details

I. General information

NPI: 1417102716
Provider Name (Legal Business Name): OAK VALLEY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S OAK AVE
OAKDALE CA
95361-3519
US

IV. Provider business mailing address

350 S OAK AVE
OAKDALE CA
95361-3519
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-3011
  • Fax: 209-848-7008
Mailing address:
  • Phone: 209-847-3011
  • Fax: 209-848-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number030000069
License Number StateCA

VIII. Authorized Official

Name: ANN CROSKREY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 209-848-4104