Provider Demographics
NPI:1336369164
Name:SCOTT VALLEY RESPIRATORY HOME CARE INC
Entity Type:Organization
Organization Name:SCOTT VALLEY RESPIRATORY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JANEEN
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-841-3000
Mailing Address - Street 1:1714 SOUTH OREGON STREET
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-3443
Mailing Address - Country:US
Mailing Address - Phone:530-841-3000
Mailing Address - Fax:
Practice Address - Street 1:1714 SOUTH OREGON STREET
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3443
Practice Address - Country:US
Practice Address - Phone:530-841-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME00952HOtherMEDI-CAL
CA0693920001Medicare ID - Type Unspecified