Provider Demographics
NPI:1861446452
Name:VERIHEALTH INC
Entity Type:Organization
Organization Name:VERIHEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-766-2400
Mailing Address - Street 1:2190 S MCDOWELL BOULEVARD EXT
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-6902
Mailing Address - Country:US
Mailing Address - Phone:707-766-2400
Mailing Address - Fax:707-766-2426
Practice Address - Street 1:2190 S MCDOWELL BOULEVARD EXT
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-6902
Practice Address - Country:US
Practice Address - Phone:707-766-2400
Practice Address - Fax:707-766-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0604667341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE01180FMedicaid
CAMTE01180FMedicaid