Organization
COPPERTOWER FAMILY MEDICAL CENTER
Active
Other names
Alexander Valley Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
JENINE SAUNDERS (CFO)
(707) 894-4229
Entity
Organization
Contact information
Practice address
6 TARMAN DRIVE, CLOVERDALE, CA 95425-3932
(707) 894-4229
(707) 894-2954
Mailing address
106 E 1ST ST, CLOVERDALE, CA 95425-3746
(707) 669-1780
(707) 894-2954
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAP53824F
FAMILY FACT
CA
05
—
RHM53824G
—
CA
01
—
ZZZ47432Z
MEDICARE PTAN NUMBER
CA
Enumeration date
02/22/2006
Last updated
06/20/2023
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