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General NPI Number Information
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NPI Number | 1336330646
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Entity Type | Organization
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Legal Business Name | SISKIYOU HOSPITAL INC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 12/26/2019
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Provider Practice Location Address
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Address Line | 8 COMMERCIAL STREET
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City | ETNA
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State | CA
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Zip | 96027
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Country | US
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Telephone | 530-467-5393
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Fax | 530-467-5355
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Provider Business Mailing Address
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Address Line | 444 BRUCE STREET
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City | YREKA
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State | CA
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Zip | 96097-3450
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Country | US
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Telephone | 530-841-6256
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Fax | 530-842-0232
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Authorized Official
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Title or Position | CEO
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Name | JONATHON C ANDRUS
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Credential |
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Telephone | 530-842-4121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 230000035
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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