Provider Demographics
NPI:1952465270
Name:FEATHER RIVER HOSPITAL
Entity Type:Organization
Organization Name:FEATHER RIVER HOSPITAL
Other - Org Name:FEATHER RIVER HOME OXYGEN AND MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER ENROLLMENT SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-876-7915
Mailing Address - Street 1:PO BOX 677000
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95967-7000
Mailing Address - Country:US
Mailing Address - Phone:530-876-7221
Mailing Address - Fax:530-876-2119
Practice Address - Street 1:5820 CANYON VIEW DR
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-5505
Practice Address - Country:US
Practice Address - Phone:530-876-7221
Practice Address - Fax:530-876-2119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230000017332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1125230001Medicare ID - Type UnspecifiedHOME OXYGEN