Organization
AMERICAN HOSPITAL MANAGEMENT CORPORATION
Active
Parent organization
AMERICAN HOSPITAL MANAGEMENT CORPORATION
Other names
Mad River Community Hospital Home Care Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HOSPITAL MANAGEMENT CORPORATION
Authorized official
DOUGLAS ALLEN SHAW (CHIEF EXECUTIVE OFFICER)
(707) 822-7220
Entity
Organization
Contact information
Practice address
4605 VALLEY WEST BLVD, ARCATA, CA 95521-4635
(707) 826-8420
(707) 826-8428
Mailing address
PO BOX 1115, ARCATA, CA 95518-1115
(707) 826-8420
(707) 826-8428
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
010000166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057524
BLUE CROSS OF CALIFORNIA
CA
05
—
HHA70137F
—
CA
01
—
ZZZ97638Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
07/27/2006
Last updated
09/20/2019
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