Organization
LAST FRONTIER HEALTHCARE DISTRICT
Active
Other names
Modoc Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN KRAMER (CEO)
(530) 708-8801
Entity
Organization
Contact information
Practice address
1111 N NAGLE ST, ALTURAS, CA 96101-3840
(530) 708-8801
(530) 233-6609
Mailing address
PO BOX 190, ALTURAS, CA 96101-0190
(530) 708-8801
(530) 233-6609
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM13988F
—
CA
01
—
ZZZ13295Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/30/2006
Last updated
12/28/2022
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