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General NPI Number Information
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NPI Number | 1497820021
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Entity Type | Organization
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Legal Business Name | MERIDIAN HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 445 PARK ST
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City | WEED
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State | CA
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Zip | 96094-2332
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Country | US
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Telephone | 530-938-4429
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 EXECUTIVE PKWY SUITE 150
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City | SAN RAMON
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State | CA
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Zip | 94583-4210
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Country | US
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Telephone | 925-855-0881
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Fax | 925-855-9297
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES R PREIMESBERGER
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Credential |
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Telephone | 213-709-4887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 230000042
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License Number State | CA
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