MEDICARE: ORCHARD HOSPITAL

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
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1689023392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORCHARD HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 97
Second Line	:
City	:	GRIDLEY
State	:	CA
Zip	:	95948-0097
Country	:	US
Telephone Number	:	530-846-9035
Fax Number	:	530-846-9075

Provider Business Practice Location Address
First Line	:	2445 ORO DAM BLVD E
Second Line	:	SUITE 8
City	:	OROVILLE
State	:	CA
Zip	:	95966-6035
Country	:	US
Telephone Number	:	530-353-3332
Fax Number	:	530-353-3335

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. STEVE STARK
Credential	:	MHA, MSOP
Telephone Number	:	530-846-9001

Provider Enumeration Date	:	06/03/2016
Last Update Date	:	06/03/2016

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Directions to “ORCHARD HOSPITAL ” Practice Location

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