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General NPI Number Information
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NPI Number | 1720166705
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Entity Type | Organization
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Legal Business Name | SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 150 CATHERINE LN
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5719
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Country | US
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Telephone | 530-274-6175
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Fax | 530-274-6234
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Provider Business Mailing Address
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Address Line | 155 GLASSON WAY
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5723
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Country | US
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Telephone | 530-274-6000
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Fax | 530-274-6234
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | CAROLYN CANADY
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Credential |
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Telephone | 530-274-6099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 230000152
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License Number State | CA
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