Basic Information
| Provider Information | |||||||||
| NPI: | 1619607488 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PAJARO VALLEY HEALTH CARE DISTRICT HOSPITAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1296 | ||||||||
| Address2: | |||||||||
| City: | CAMBRIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934281296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6508687305 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 NIELSON ST | ||||||||
| Address2: | |||||||||
| City: | WATSONVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950762468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317244741 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2022 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | FRIEL | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHAIR OF BOARD | ||||||||
| AuthorizedOfficialTelephone: | 2096149351 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 333600000X | N | Suppliers | Pharmacy | 3336C0003X | N | Suppliers | Pharmacy | Community/Retail Pharmacy | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.