Provider Demographics
NPI:1982956173
Name:PET CARE VETERINARY HOSPITAL, INC.
Entity Type:Organization
Organization Name:PET CARE VETERINARY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-SR. PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:707-579-3900
Mailing Address - Street 1:1370 FUTTON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401
Mailing Address - Country:US
Mailing Address - Phone:707-579-5900
Mailing Address - Fax:707-579-9512
Practice Address - Street 1:2425 MENDOCINO AVE.
Practice Address - Street 2:
Practice Address - City:SANTA ROSA,
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:707-579-3900
Practice Address - Fax:707-303-3169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty