MEMORIAL MEDICAL CENTER NPI 1073673737

NPI Information

NPI: 1073673737
Provider Name: MEMORIAL MEDICAL CENTER
Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

CLIA Number: 05D0609849

Address:
1700 COFFEE ROAD
MODESTO, CA
ZIP 95355
Phone: (209) 526-4500
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MEMORIAL MEDICAL CENTER is a critical access general acute care hospital in Modesto, CA. The provider is definition to come. MEMORIAL MEDICAL CENTER NPI is 1073673737. The provider is registered as an organization entity type.

The provider's business location address is:

1700 COFFEE ROAD
MODESTO, CA
ZIP 95355-803
Phone: (209) 526-4500

The provider's authorized official is Brian Trent Hunter .
The authorized official title is Vp Shared Services and has the following contact phone number (916) 297-8555.

The CLIA number assigned to this NPI record is 05D0609849 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 12/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	352732	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	050557	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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