Provider Demographics
NPI:1952198012
Name:SOUTHERN HUMBOLDT COMMUNITY HEALTHCARE DISTRICT
Entity type:Organization
Organization Name:SOUTHERN HUMBOLDT COMMUNITY HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-923-3921
Mailing Address - Street 1:733 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:GARBERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95542-3201
Mailing Address - Country:US
Mailing Address - Phone:707-923-3921
Mailing Address - Fax:
Practice Address - Street 1:630 9TH ST
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-2324
Practice Address - Country:US
Practice Address - Phone:707-923-3921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty