Organization
DIGNITY HEALTH
Active
Parent organization
DIGNITY HEALTH
Other names
Mercy Hospice Mt. Shasta
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH
Authorized official
KIM MIRANDA (CHIEF FINANCIAL OFFICER)
(530) 225-6121
Entity
Organization
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-9321
(530) 926-9396
Mailing address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-9321
(530) 926-9396
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
100000756
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721561129
IRS FEDERAL TAX ID #
CA
01
—
721561129960670002
CHAMPUS TRICARE HOSPICE
AR
05
—
HPC01736G
—
CA
Enumeration date
03/29/2007
Last updated
06/10/2014
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