Promedical Family Pratice

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

G86543 Issued in CA

Legal business name

PROMEDICAL FAMILY PRATICE

Practice address

815 7TH St
Eureka, CA 95501-1113

Phone

(707) 407-0540

Fax

(707) 268-5573

NPI assigned

Mar 1, 2012

Last updated

Mar 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Claude Vernon Coleman, LVN

Title

Admenistrator

Phone

(707) 407-0540

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1447524921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 7TH ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011113",
            "telephone_number": "707-407-0540",
            "fax_number": "707-268-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 7TH ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011113",
            "telephone_number": "707-407-0540",
            "fax_number": "707-268-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICAL FAMILY PRATICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "ADMENISTRATOR",
        "authorized_official_telephone_number": "707-407-0540",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "G86543",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "16089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Prichard
• Matthew Prim
• Pamela Prindle, RN
• Sandra Pritchard, RN
• Pavel Prokopchuk
• Ronald Propst, RPH
• Gary Prosser
• Providence Medical Foundation
• Providence Medical Foundation
• Providence Medical Foundation

• Health Service Clinic/Center in Eureka, CA
• Providers in Eureka, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.