Provider Demographics
NPI:1023038841
Name:COUNTY OF TUOLUMNE
Entity Type:Organization
Organization Name:COUNTY OF TUOLUMNE
Other - Org Name:TUOLUMNE GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-533-5551
Mailing Address - Street 1:101 HOSPITAL RD
Mailing Address - Street 2:TGH ME GRP - CARDIO
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5227
Mailing Address - Country:US
Mailing Address - Phone:209-533-7100
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPITAL RD
Practice Address - Street 2:TGH ME GRP - CARDIO
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5227
Practice Address - Country:US
Practice Address - Phone:209-533-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000107282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ92806ZMedicare Oscar/Certification