Provider Demographics
NPI:1467880583
Name:OROVILLE HOSPITAL
Entity Type:Organization
Organization Name:OROVILLE HOSPITAL
Other - Org Name:DOVES LANDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-532-8509
Mailing Address - Street 1:2450 ORO DAM BLVD E
Mailing Address - Street 2:SUITE B
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6052
Mailing Address - Country:US
Mailing Address - Phone:530-533-1234
Mailing Address - Fax:530-533-5678
Practice Address - Street 1:2450 ORO DAM BLVD E
Practice Address - Street 2:SUITE B
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6052
Practice Address - Country:US
Practice Address - Phone:530-533-1234
Practice Address - Fax:530-533-5678
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OROHEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-29
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA546463336C0003X
3336C0002X
CA516223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1467880583Medicaid