Provider Demographics
NPI:1114917564
Name:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL
Other - Org Name:MEE MEMORIAL HEALTHCARE SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMACHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-385-7284
Mailing Address - Street 1:300 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:CA
Mailing Address - Zip Code:93930-3431
Mailing Address - Country:US
Mailing Address - Phone:831-385-6000
Mailing Address - Fax:831-385-7188
Practice Address - Street 1:300 CANAL ST
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930-3431
Practice Address - Country:US
Practice Address - Phone:831-385-6000
Practice Address - Fax:831-385-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000D47282N00000X
282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZM6443ZOtherBS SNF / SWING PROVIDER #
CA05Z336OtherMEDICARE CERTIFICATION NUMBER (CCN)/PTAN
CA051336OtherMEDICARE CERTIFICATION NUMBER (CCN)/PTAN
CA050189A000000OtherTRAILBLAZER
CA05U189Medicare Oscar/Certification
CAZZZ23952ZMedicare PIN
CAZZZM6443ZOtherBS SNF / SWING PROVIDER #
CA056443Medicare Oscar/Certification
CAZZZ99383ZMedicare PIN