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General NPI Number Information
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NPI Number | 1578890653
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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 | 11/10/2009
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 700 S MAIN ST
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City | YREKA
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State | CA
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Zip | 96097-3354
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Country | US
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Telephone | 530-842-0817
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Fax | 530-842-3597
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Provider Business Mailing Address
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Address Line | 444 BRUCE ST
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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 | 530-842-4121
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Fax | 530-841-0913
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JONATHON 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 |
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License Number State |
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