Organization
SISKIYOU HOSPITAL INC
Active
Parent organization
SISKIYOU HOSPITAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SISKIYOU HOSPITAL INC
Authorized official
JONATHON C ANDRUS (CEO)
(530) 842-4121
Entity
Organization
Contact information
Practice address
8 COMMERCIAL STREET, ETNA, CA 96027
(530) 467-5393
(530) 467-5355
Mailing address
444 BRUCE STREET, YREKA, CA 96097-3450
(530) 841-6256
(530) 842-0232
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
230000035
CA
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BCP18517F
—
CA
05
—
RHM18517F
—
CA
Enumeration date
08/05/2007
Last updated
12/26/2019
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