Providence Santa Rosa Memorial Hospital
LBN: St. Joseph Health Northern California, Llc
Providence Santa Rosa Memorial Hospital is an health care organization with primary practice located at 1165 Montgomery Dr , Santa Rosa CA 95405. The organization recently has only one registered license in Hospitals / General Acute Care Hospital, which is considered as the primary health care specialty.
St. Joseph Health Northern California, Llc can be contacted via phone (707) 525-5300, or through Anderson, Donald Wayne via phone (425) 525-5392.
Contact Information
Primary practice address
1165 Montgomery Dr
Santa Rosa CA 95405
Phone: (707) 525-5300
Fax: (707) 525-5392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Hospitals / General Acute Care Hospital | 282N00000X | 140000648 | California |
Profile Details
| NPI number | 1134152549 |
|---|---|
| LBN Legal business name | St. Joseph Health Northern California, Llc |
| DBA Doing business as | Providence Santa Rosa Memorial Hospital |
| Authorized official | Anderson, Donald Wayne |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jul 9th, 2006 |
| Last updated | Jun 22nd, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134152549 | NPPES |
| California | MEDICAID | HSM00174F | |
| California | MEDICAID | HSP40174F | |
| California | MEDICAID | ZZR00174F |
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