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Organization
SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
Active
Organization
SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
Active
Parent organization
SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
Other names
Sierra Nevada Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
Authorized official
CAROLYN CANADY (CHIEF FINANCAIL OFFICER)
(530) 274-6099
Entity
Organization
Contact information
Practice address
1155 E MAIN ST, GRASS VALLEY, CA 95945-5723
(530) 274-6350
(530) 274-6747
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
(530) 274-6350
(530) 274-6747
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
230000138
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057755-001
BLUE CROSS
CA
01
—
4509
BLUE CROSS
CA
01
—
5720703
KAISER
—
01
—
680106483959490047
WPS TRICARE
—
01
—
=========
IRS
—
01
—
HA0006
ALTA
CA
05
—
HHA07755F
—
CA
01
—
ZZZ14789Z
BLUE SHIELD OF CA
—
Enumeration date
06/09/2005
Last updated
07/26/2023
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