MACT HEALTH BOARD, INC. (NPI# 1295727287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295727287 |
Entity Type | Organization |
Organization Name | MACT HEALTH BOARD, INC. |
Other Organization Name | MACT MEDICAL JACKSON |
Practice Address |
12140/12150 New York Ranch Rd Jackson CA 95642-9407 |
Mailing Address |
Po Box 939 Angels Camp CA 95222-0939 |
Practice Telephone | 2092572400 |
Practice Fax Number | 2092572403 |
Mailing Telephone | 2097546262 |
Mailing Fax Number | 2097546274 |
Enumeration Date | 2005-08-17 |
Last Update Date | 2018-09-26 |
Authorized Official Name | MR. JOHN ALEXANDER (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 2097546262 |
Is Organization Subpart | Y |
Parent Organization Name | MACT HEALTH BOARD, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | THP70776F | 05 |
Other Name | Type Code |
---|---|
Jackson Rancheria Health Complex | Doing Business As Name - Organization |
MACT Medical Jackson | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417505918 | Mact Health Board, Inc. | Dentist | 52 S Main Street, Suite B, Angels Camp, CA 95222 | 2019-08-28 |
1528508488 | Mact Health Board, Inc. | Optometrist | 1113a Highway 49, San Andreas, CA 95249 | 2017-02-27 |
1366519431 | Mact Health Board, Inc. | Clinic/Center | 1113 Highway 49, San Andreas, CA 95249 | 2006-11-30 |
1346410255 | Mact Health Board, Inc. | Clinic/Center | 1113 Hwy 49, San Andreas, CA 95249-9583 | 2008-03-06 |
1740272731 | Mact Health Board, Inc. | Clinic/Center | 5192 Hospital Rd, Mariposa, CA 95338-9524 | 2005-08-17 |
1467444364 | Mact Health Board, Inc. | Clinic/Center | 13975 Mono Way, Suite G, H & I, Sonora, CA 95370-2824 | 2005-08-17 |
Street Address |
12140/12150 NEW YORK RANCH RD |
City | JACKSON |
State | CA |
Zip Code | 95642-9407 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
Find all providers in zip 95642 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972150084 | Wound Management Specialists, LLC | Clinic/Center | 1190 N State St Ste 2a, Jackson, MS 39202-2413 | 2019-08-22 |
1700449329 | Cycle 8 Health Care, LLC | Clinic/Center | 2310 Highway 80 W Ste 2260, Jackson, MS 39204-2383 | 2019-04-18 |
1093286544 | East Endocrine and Metabolism Pllc | Clinic/Center | 3829 Greentree Pl, Jackson, MS 39211-6737 | 2018-12-10 |
1760965206 | Hunter Assets Holding LLC | Clinic/Center | 1035 W Mayes St, Jackson, MS 39213-6100 | 2018-09-11 |
1235634759 | W A Foote Memorial Hospital Inc | Clinic/Center | 2200 Springport Rd Ste 230, Jackson, MI 49202-1432 | 2018-03-27 |
1336644897 | W A Foote Memorial Hospital Inc | Clinic/Center | 3305 Spring Arbor Rd Ste 500, Jackson, MI 49203-3795 | 2018-03-27 |
1730684580 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 210, Jackson, MI 49202-1432 | 2018-03-26 |
1164927844 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 800, Jackson, MI 49202-1432 | 2018-03-26 |
1225532120 | Robert Greer Do, LLC | Clinic/Center | 5345 Farnsworth Dr, Jackson, MS 39211-4604 | 2018-03-23 |
1447761713 | Celestial Health Creations | Clinic/Center | 7 Lakeland Cir Ste 300, Jackson, MS 39216-5022 | 2017-10-13 |
Find all providers in JACKSON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.