Organization
SAN GORGONIO MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAYDA L. BROWN (DIRECTOR PT. FIN. SVC.)
(951) 769-2170
Entity
Organization
Contact information
Practice address
600 N HIGHLAND SPRINGS AVE, BANNING, CA 92220-3046
(951) 845-1121
(951) 769-0431
Mailing address
600 N HIGHLAND SPRINGS AVE, BANNING, CA 92220-3046
(951) 845-1121
(951) 769-0431
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
250001199
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050054
MEDICARE PROVIDER NUMBER
CA
01
—
HSC30054G
MEDICAID IP PROV
CA
01
—
ZZT30054G
MEDICAID INPT PROV NUMBER
CA
05
—
ZZT30054G
—
CA
01
—
ZZT40054G
MEDICAID OP PROVIDER NO
CA
05
—
ZZT40054G
—
CA
Enumeration date
06/30/2005
Last updated
11/13/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us