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General NPI Number Information
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NPI Number | 1356388961
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Entity Type | Organization
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Legal Business Name | GLENN MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 1133 W SYCAMORE ST
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City | WILLOWS
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State | CA
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Zip | 95988-2601
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Country | US
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Telephone | 530-934-1800
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Fax | 530-934-1818
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Provider Business Mailing Address
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Address Line | 1133 W SYCAMORE ST
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City | WILLOWS
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State | CA
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Zip | 95988-2601
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Country | US
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Telephone | 530-934-1800
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Fax | 530-934-1818
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Authorized Official
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Title or Position | VP FINANCE/CFO
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Name | TAMMY THOMPSON
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Credential |
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Telephone | 209-287-6308
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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 | 23000001
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License Number State | CA
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