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Organization

PRIDE INDUSTRIES ONE, INC.

Active
Parent organization
PRIDE INDUSTRIES
Other names
CTSA of Placer County
Organization subpart
Yes

Provider details

NPI number
Legal business name
PRIDE INDUSTRIES
Authorized official
JOAN PEDERSON (TRANSPORTATION MANAGER)
(916) 788-2327
Entity
Organization

Contact information

Practice address
10030 FOOTHILLS BLVD, M/S 26, ROSEVILLE, CA 95747-5178
(916) 788-2100
Mailing address
10030 FOOTHILLS BLVD, M/S 26, ROSEVILLE, CA 95747-5178
(916) 788-2100

Taxonomy

Speciality
Code
Description
License number
State
347B00000X
Bus
Primary
CA-45685
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MTN00615F
MEDI-CAL
CA
Enumeration date
08/14/2008
Last updated
08/14/2008
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