Provider Demographics
NPI:1306008222
Name:CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION- NORWOOD CLINIC
Entity Type:Organization
Organization Name:CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION- NORWOOD CLINIC
Other - Org Name:MERCY CLINIC NORWOOD
Other - Org Type:Other Name
Authorized Official - Title/Position:GROUP PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-851-2082
Mailing Address - Street 1:3911 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-3361
Mailing Address - Country:US
Mailing Address - Phone:916-929-8575
Mailing Address - Fax:916-929-3548
Practice Address - Street 1:3911 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-3361
Practice Address - Country:US
Practice Address - Phone:916-929-8575
Practice Address - Fax:916-929-3548
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA5161OtherRAILROAD MEDICARE
CAGR0091670Medicaid
ZZZ22582ZMedicare Oscar/Certification