Lodi Memorial Hospital Association Inc | |
305 Preston Ave Ione CA 95640 | |
(209) 274-2183 | |
(209) 339-7659 |
Full Name | Lodi Memorial Hospital Association Inc |
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Speciality | Clinic/center |
Location | 305 Preston Ave, Ione, California |
Authorized Official Name and Position | Jason Whitney (FINANCE OFFICER) |
Authorized Official Contact | 2093397477 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lodi Memorial Hospital Association Inc Po Box 884577 Los Angeles CA 90088-4577 Ph: (209) 334-3411 | Lodi Memorial Hospital Association Inc 305 Preston Ave Ione CA 95640 Ph: (209) 274-2183 |
NPI Number | 1750391710 |
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Provider Enumeration Date | 08/09/2006 |
Last Update Date | 01/06/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750391710 | NPI | - | NPPES |
GR0086835 | Medicaid | CA | |
ZZZ53493Z | Other | CA | BLUE SHIELD PROV GRP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 030000056 (California) | Primary |