Organization
ADVENTIST HEALTH MENDOCINO COAST
Active
Other names
Mendocino Coast District Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC STEVENS (PRESIDENT)
(707) 456-3010
Entity
Organization
Contact information
Practice address
700 RIVER DR, FORT BRAGG, CA 95437-5403
(707) 961-1234
(707) 961-4901
Mailing address
700 RIVER DR, FORT BRAGG, CA 95437-5403
(707) 961-1234
(707) 961-4901
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
110000040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050569
BLUE CROSS
—
01
—
952627981
COMMERCIAL
CA
01
—
HSP40569F
MEDICAL OUTPATIENT
—
01
—
LTC30569F
MEDICAL SWING BED
—
01
—
MTE00312F
MEDICAL AMBULANCE
—
01
—
PHB160620
MEDICAL PHARMACY
—
05
—
ZZR00569F
—
CA
01
—
ZZZ14750Z
BLUE SHIELD
CA
01
—
ZZZ36026Z
BLUE SHIELD INFUSION
CA
01
—
ZZZ39861Z
BLUE SHIELD
CA
01
—
ZZZ57360Z
BLUE SHIELD CLINIC
CA
01
—
ZZZ96931Z
BLUE SHIELD ER
CA
01
—
ZZZA2301Z
BLUE SHIELD HOSPITAL
CA
Enumeration date
05/20/2006
Last updated
07/18/2025
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