Cloverdale Hospital District Ambulance

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

CLOVERDALE HOSPITAL DISTRICT AMBULANCE

Practice address

209 N Main St
Cloverdale, CA 95425-3333

Phone

(707) 894-5862

Fax

(707) 894-9532

NPI assigned

Jan 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas K Hinrichs

Title

Ceo

Phone

(707) 894-5862

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cloverdale Health Care District Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1295886786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 N MAIN ST",
            "address_2": "P.O. BOX 33",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954253333",
            "telephone_number": "707-894-5862",
            "fax_number": "707-894-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N MAIN ST",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954253333",
            "telephone_number": "707-894-5862",
            "fax_number": "707-894-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERDALE HOSPITAL DISTRICT AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-13",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "HINRICHS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-894-5862",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ82638Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cloverdale Health Care District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maria Jesus Alvarez, PH.D.
• Gina Simone Berry, MS, RD, CSP
• Fred Paul Besio, RPH
• Catherine C Chu, L.AC.
• Cloverdale Counseling Center, Inc.
• Cloverdale Unified School District
• Coppertower Family Medical Center
• Coppertower Family Medical Center
• Coppertower Family Medical Center
• Coppertower Family Medical Center

• All providers in Cloverdale, CA
• Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.