Provider Demographics
NPI:1043348543
Name:PLUMAS DISTRICT HOSPITAL
Entity Type:Organization
Organization Name:PLUMAS DISTRICT HOSPITAL
Other - Org Name:PLUMAS RURAL HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-283-7127
Mailing Address - Street 1:1065 BUCKS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-9507
Mailing Address - Country:US
Mailing Address - Phone:530-283-7161
Mailing Address - Fax:530-283-7953
Practice Address - Street 1:1065 BUCKS LAKE RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971-9507
Practice Address - Country:US
Practice Address - Phone:530-283-7161
Practice Address - Fax:530-283-7953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLUMAS DISTRICT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-28
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230000030261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA053989Medicare Oscar/Certification