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General NPI Number Information
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NPI Number | 1508105354
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Entity Type | Organization
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Legal Business Name | SUTTER CENTRAL VALLEY HOSPITALS
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Dates
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Enumeration Date | 02/13/2013
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 1420 N. TRACY BLVD.
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City | TRACY
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State | CA
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Zip | 95376
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Country | US
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Telephone | 209-832-6004
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Fax | 209-832-6599
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Provider Business Mailing Address
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Address Line | 1420 N. TRACY BLVD.
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City | TRACY
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State | CA
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Zip | 95376
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID M. THOMPSON
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Credential |
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Telephone | 209-832-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | HSP49989
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License Number State | CA
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