Provider Demographics
NPI:1205808375
Name:PAJARO VALLEY HEALTH CARE DISTRICT HOSPITAL CORPORATION (PVHCDHC)
Entity type:Organization
Organization Name:PAJARO VALLEY HEALTH CARE DISTRICT HOSPITAL CORPORATION (PVHCDHC)
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATKO
Authorized Official - Middle Name:
Authorized Official - Last Name:VRANJES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-763-6040
Mailing Address - Street 1:75 NIELSON STREET
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2468
Mailing Address - Country:US
Mailing Address - Phone:831-763-6040
Mailing Address - Fax:831-728-4758
Practice Address - Street 1:75 NIELSON STREET
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2468
Practice Address - Country:US
Practice Address - Phone:831-763-6040
Practice Address - Fax:831-728-4758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0580945OtherNABP
CAPHB438410Medicaid