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Organization

MID VALLEY HEALTH SERVICES LONG TERM CARE INC

Active
Other names
MID VALLEY HEALTH SERVICES LONG TERM CARE
Organization subpart
No

Provider details

NPI number
Authorized official
HAROLD STOLL (COO)
(209) 552-7600
Entity
Organization

Contact information

Practice address
602 SCENIC DR, MODESTO, CA 95350-6128
(209) 552-7600
(209) 552-7638
Mailing address
602 SCENIC DR, MODESTO, CA 95350-6128
(209) 552-7600
(209) 552-7638

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHY49880
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2113493
PK
Enumeration date
05/01/2008
Last updated
09/21/2016
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