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General NPI Number Information
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NPI Number | 1962444059
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Entity Type | Organization
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Legal Business Name | SOUTHERN MONO HEALTH CARE DISTRICT
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 85 SIERRA PARK RD
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City | MAMMOTH LAKES
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State | CA
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Zip | 93546-2073
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Country | US
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Telephone | 760-934-3311
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Fax | 760-924-4149
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Provider Business Mailing Address
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Address Line | PO BOX 660 85 SIERRA PARK RD.
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City | MAMMOTH LAKES
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State | CA
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Zip | 93546
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Country | US
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Telephone | 760-934-3311
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Fax | 760-924-4149
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. MELANIE VAN WINKLE
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Credential |
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Telephone | 760-934-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 240000008
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License Number State | CA
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