Healthcare Provider Details

I. General information

NPI: 1285657130
Provider Name (Legal Business Name): TUOLUMNE GENERAL HOSPITAL PHCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL RD
SONORA CA
95370-5227
US

IV. Provider business mailing address

101 HOSPITAL RD
SONORA CA
95370-5227
US

V. Phone/Fax

Practice location:
  • Phone: 702-533-7103
  • Fax: 702-533-7293
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberHPE46824
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE HEBERT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 209-533-7135