Provider Demographics
NPI:1770296220
Name:ALLMED OF SACRAMENTO
Entity type:Organization
Organization Name:ALLMED OF SACRAMENTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GLOBAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGROVE BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-303-0779
Mailing Address - Street 1:2485 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4344
Mailing Address - Country:US
Mailing Address - Phone:916-281-2251
Mailing Address - Fax:916-400-9056
Practice Address - Street 1:2485 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-4344
Practice Address - Country:US
Practice Address - Phone:916-281-2251
Practice Address - Fax:916-400-9056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH26053711001742OtherTAX EXEMPT AND GOVERMENT ENTITIES IRS LETTER