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General NPI Number Information
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NPI Number | 1629630314
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Entity Type | Organization
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Legal Business Name | ARCHWAY HEALTH CARE SERVICES INC
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 8950 CAL CENTER DR STE 112
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City | SACRAMENTO
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State | CA
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Zip | 95826-3236
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Country | US
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Telephone | 209-405-9888
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Fax | 916-376-7467
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Provider Business Mailing Address
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Address Line | 8950 CAL CENTER DR STE 112
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City | SACRAMENTO
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State | CA
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Zip | 95826-3236
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Country | US
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Telephone | 209-405-9888
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Fax | 916-376-7467
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Authorized Official
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Title or Position | OWNER
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Name | IAN JOHNSON
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Credential | MD
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Telephone | 209-405-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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