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NPI Code Detail

MEDICARE: LAST FRONTIER HEALTHCARE DISTRICT

MEDICARE: LAST FRONTIER HEALTHCARE DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2ZZZ13295ZOTHERCABLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number : 1487764064
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAST FRONTIER HEALTHCARE DISTRICT
Provider Business Mailing Address
First Line : PO BOX 190
Second Line :
City : ALTURAS
State : CA
Zip : 96101-0190
Country : US
Telephone Number : 530-708-8801
Fax Number : 530-233-6609
Provider Business Practice Location Address
First Line : 1111 N NAGLE ST
Second Line :
City : ALTURAS
State : CA
Zip : 96101-3840
Country : US
Telephone Number : 530-708-8801
Fax Number : 530-233-6609
Authorized Official
Title or Position : CEO
Name : KEVIN KRAMER
Credential :
Telephone Number : 530-708-8801
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/28/2022

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Directions to “LAST FRONTIER HEALTHCARE DISTRICT ” Practice Location

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