Provider Demographics
NPI:1790396547
Name:OAK VALLEY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:OAK VALLEY HOSPITAL DISTRICT
Other - Org Name:THE EDGE OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSKREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-848-4104
Mailing Address - Street 1:350 S OAK AVE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-3519
Mailing Address - Country:US
Mailing Address - Phone:209-848-7044
Mailing Address - Fax:209-848-7008
Practice Address - Street 1:250 S OAK AVE STE A4
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-3572
Practice Address - Country:US
Practice Address - Phone:209-848-5310
Practice Address - Fax:209-848-7074
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAK VALLEY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-14
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine