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General NPI Number Information
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NPI Number | 1841294782
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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 | 06/09/2005
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 1155 E MAIN ST
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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 | 530-274-6350
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Fax | 530-274-6747
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Provider Business Mailing Address
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Address Line | 3400 DATA DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-7956
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Country | US
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Telephone | 530-274-6350
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Fax | 530-274-6747
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Authorized Official
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Title or Position | CHIEF FINANCAIL 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 230000138
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License Number State | CA
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