Pacific Medical Resources, Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PACIFIC MEDICAL RESOURCES, INC.

Doing business as

Mendocino/Lake/Humboldt/Pacific Caregivers and Mendocino Nursing Servi

Practice address

1102 S Main St
Suite #3
Fort Bragg, CA 95437-5305

Phone

(707) 964-2000

NPI assigned

Jun 3, 2016

Organization subpart

No

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

Authorized official

Name

Emma Carter

Title

Owner

Phone

(707) 964-2000

Specialties & licenses 1

Addresses

Other names 1

• Mendocino/Lake/Humboldt/Pacific Caregivers and Mendocino Nursing Servi Doing business as

Locations

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1437508132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SOUTH MAIN STREET",
            "address_2": "SUITE #3",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S MAIN ST",
            "address_2": "SUITE #3",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375305",
            "telephone_number": "707-964-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "EMMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-964-2000"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mendocino/Lake/Humboldt/Pacific Caregivers and Mendocino Nursing Servi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Exclusive Provider Organization in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.