Provider Demographics
NPI:1902836364
Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity Type:Organization
Organization Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE, JR.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-450-8521
Mailing Address - Street 1:2800 L ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5616
Mailing Address - Country:US
Mailing Address - Phone:916-454-6525
Mailing Address - Fax:916-454-6526
Practice Address - Street 1:2800 L ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5616
Practice Address - Country:US
Practice Address - Phone:916-454-6525
Practice Address - Fax:916-454-6526
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-03
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-1652Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER