Provider Demographics
NPI:1093771073
Name:ARTEL LLC
Entity Type:Organization
Organization Name:ARTEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-339-7477
Mailing Address - Street 1:PO BOX 884577
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-4577
Mailing Address - Country:US
Mailing Address - Phone:209-333-0905
Mailing Address - Fax:209-333-5243
Practice Address - Street 1:521 S HAM LN
Practice Address - Street 2:SUITE F
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3528
Practice Address - Country:US
Practice Address - Phone:209-333-0905
Practice Address - Fax:209-333-0219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LODI MEMORIAL HOSPITAL ASSOCIATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-26
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000345261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASUR01056GMedicaid
CASUR01056GMedicaid