Healthcare Provider Details
I. General information
NPI: 1174615330
Provider Name (Legal Business Name): EMANUEL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2006
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 DELBON AVE
TURLOCK CA
95382-2016
US
IV. Provider business mailing address
PO BOX 819005
TURLOCK CA
95381-9005
US
V. Phone/Fax
- Phone: 209-667-4200
- Fax: 209-664-5007
- Phone: 209-667-4200
- Fax: 209-664-5007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 030000035 |
| License Number State | CA |
VIII. Authorized Official
Name:
DAVID
A.
NEAPOLITAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 209-664-5000