Provider Demographics
NPI:1861009672
Name:NORCAL HEALTHCONNECT LLC
Entity Type:Organization
Organization Name:NORCAL HEALTHCONNECT LLC
Other - Org Name:HEALDSBURG HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY FOR ENROLLMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:425-525-5392
Mailing Address - Street 1:PO BOX 31001-3085
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-3085
Mailing Address - Country:US
Mailing Address - Phone:707-431-6500
Mailing Address - Fax:
Practice Address - Street 1:1375 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3382
Practice Address - Country:US
Practice Address - Phone:707-431-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282N00000XHospitalsGeneral Acute Care Hospital