Organization
AMERICAN HOSPITAL MANAGEMENT CORPORATION
Active
Other names
MAD RIVER COMMUNITY HOSPITAL, MAD RIVER EXPRESS CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS ALLEN SHAW (CHIEF EXECUTIVE OFFICER)
(707) 822-7220
Entity
Organization
Contact information
Practice address
3800 JANES RD, ARCATA, CA 95521-4742
(707) 822-3621
Mailing address
PO BOX 1115, ARCATA, CA 95518-1115
(707) 822-3621
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
PENDING
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609979707
—
CA
Enumeration date
09/06/2006
Last updated
09/20/2019
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