| Southern Humboldt Community Healthcare District | |
|
509 Elm St Garberville CA 95542-3204 | |
| (707) 923-3921 | |
| (707) 923-1456 |
| Full Name | Southern Humboldt Community Healthcare District |
|---|---|
| Speciality | Clinic/Center |
| Location | 509 Elm St, Garberville, California |
| Authorized Official Name and Position | Susan Lee Gardner (MED STAFF COORDINATOR) |
| Authorized Official Contact | 7079233921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Humboldt Community Healthcare District 733 Cedar St Garberville CA 95542-3201 Ph: (707) 923-3921 | Southern Humboldt Community Healthcare District 509 Elm St Garberville CA 95542-3204 Ph: (707) 923-3921 |
| NPI Number | 1336367515 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 07/01/2021 |
| Medicare PECOS PAC ID | 8820982879 |
|---|---|
| Medicare Enrollment ID | O20091113000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336367515 | NPI | - | NPPES |
| 174988 | Medicaid | AZ | |
| 272260 | Medicaid | OR | |
| RHM03921G | Other | CA | MEDI-CAL |
| 3003993 | Medicaid | WA | |
| ZZZ05354Z | Other | CA | BLUE SHIELD CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 110000052 (California) | Primary |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 Elm St, Garberville, CA 95542 Phone: 707-463-2400 Fax: 707-463-3520 |