ADVENTIST HEALTH PET/CT - ST. HELENA (RCOA-ADVENTIST HEALTH, LLC) NPI 1336194497

Clinic/Center (Radiology, Mobile) in Saint Helena, CA

NPI 1336194497 Organization Clinic/Center Radiology, Mobile CLIA Number 05D0643777 CLIA Certificate of Accreditation

About ADVENTIST HEALTH PET/CT - ST. HELENA (RCOA-ADVENTIST HEALTH, LLC)

Adventist Health Pet/ct - St. Helena (rcoa-adventist Health, Llc) is a provider established in Saint Helena, California specializing in clinic/center (radiology, mobile) . The NPI number of Adventist Health Pet/ct - St. Helena (rcoa-adventist Health, Llc) is 1336194497 and was assigned on May 2006. The practitioner's primary taxonomy code is 261QR0208X with license number 6838-17 (CA). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Adventist Health Pet/ct - St. Helena. The authorized official of this NPI record is Mr. Allen Mcgee (Chairman & Ceo)

The CLIA number of Adventist Health Pet/ct - St. Helena is 05D0643777 registered as a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued to Adventist Health Pet/ct - St. Helena on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

NPI

1336194497

Provider NameADVENTIST HEALTH PET/CT - ST. HELENA (RCOA-ADVENTIST HEALTH, LLC)
Provider Location Address10 WOODLAND RD SAINT HELENA, CA 94574
Provider Mailing AddressP. O. BOX 85001 ORLANDO, FL 32885
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameADVENTIST HEALTH PET/CT - ST. HELENA
Other Name TypeDoing Business As (3)
Enumeration Date05-24-2006
Last Update Date08-13-2008


Primary Taxonomy

Taxonomy Code261QR0208X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRadiology, Mobile
License No.6838-17
License StateCA

Business Address

ADVENTIST HEALTH PET/CT - ST. HELENA
10 WOODLAND RD
SAINT HELENA, CA
ZIP 94574
Phone: (866) 293-3500
Fax: (866) 293-3535

Get Directions


Mailing Address

ADVENTIST HEALTH PET/CT - ST. HELENA
P. O. BOX 85001
ORLANDO, FL
ZIP 32885
Phone: (866) 293-3500
Fax: (866) 293-3535



Authorized Official

Authorized Official NameMR. ALLEN MCGEE
Authorized Official TitleCHAIRMAN & CEO
Authorized Official Phone(561) 477-3500

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1336194497 is:

CLIA Number05D0643777
Facility TypeHOSPITAL
Certificate TypeCertificate of Accreditation

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
ZZZ31885ZMEDICARE ID-TYPE UNSPECIFIED (04)CA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1275535700 WILLIAM DUGE MD
Individual
Radiology (Diagnostic Radiology)10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 261-7821
1104812585DR. HIROFUMI HASHIMOTO MD
Individual
Internal Medicine10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6399
1619950193 EDWARD STUMP M.D.
Individual
Emergency Medicine10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6311
1033192547 DAN CLAY M.D.
Individual
Emergency Medicine10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6311
1174507552 EDWIN CARLSON M.D.
Individual
Emergency Medicine10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-3611
1912981382 GARY MISHKIN M.D.
Individual
Emergency Medicine10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-3611
1508840513 JOSE RENE MIRANDA M.D.
Individual
Emergency Medicine10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-3611
1851355705 ANDREW DEMETRIUS HORPENIUK M.D., M.P.H.
Individual
Preventive Medicine (Occupational Medicine)10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6491
1083679781DR. DAVID R RACKER M.D.
Individual
Radiology (Diagnostic Radiology)10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6430
1659320703DR. ETHAN DALIERE SCHRAM M.D.
Individual
Internal Medicine (Medical Oncology)10 WOODLAND RD MARTIN-O'NEIL CANCER CENTER
SAINT HELENA, CA 94574
(707) 967-5721
1922020221 DAVID KIM M.D.
Individual
Hospitalist10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6399
1205859683 DIANE LYNN HAMBRICK M.D.
Individual
Family Medicine (Addiction Medicine)10 WOODLAND RD ST. HELENA HOSPITAL
SAINT HELENA, CA 94574
(707) 967-5720
1881703973DR. HEATHER M. PENA M.D.
Individual
Internal Medicine10 WOODLAND RD CENTER FOR HEALTH
SAINT HELENA, CA 94574
(707) 963-6362
1689778987DR. STEVEN CARLTON HERBER MD
Individual
Surgery (Plastic and Reconstructive Surgery)10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 967-5981
1962508960 CAROL L ISAACS MD
Individual
Dermatology10 WOODLAND RD LLOYD BLDG STE 501
ST HELENA, CA 94574
(707) 963-5450
1386856888 JOANNE HATCH R.D.
Individual
Dietitian, Registered10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6218
1730396433 MAILE SHUBIN
Individual
Dietitian, Registered10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-3218
1558578013 PETRA SCHLENKE R.D.
Individual
Dietitian, Registered10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6432
1013117977DR. GEOFFREY WILLIAM HORN DO
Individual
Radiology (Diagnostic Radiology)10 WOODLAND RD
SAINT HELENA, CA 94574
(707) 963-6430
1174793574ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Organization
Psychiatry & Neurology (Neurology)10 WOODLAND RD SUITE 502
SAINT HELENA, CA 94574
(707) 963-1882

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.