MARSHALL MEDICAL CENTER (NPI# 1346226693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346226693 |
| Entity Type | Organization |
| Organization Name | MARSHALL MEDICAL CENTER |
| Other Organization Name | DIVIDE WELLNESS CENTER |
| Practice Address |
6065 State Hwy 193 Georgetown CA 95634-9623 |
| Mailing Address |
Po Box 45680 San Fransisco CA 94145-0680 |
| Practice Telephone | 5303332555 |
| Practice Fax Number | 5303332832 |
| Mailing Telephone | 5303332555 |
| Mailing Fax Number | 5303332832 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | LAURIE ELDRIDGE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5306262780 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Divide Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356904577 | Marshall Medical Center | Clinic/Center | 3581 Palmer Dr Ste 202, Cameron Park, CA 95682-8237 | 2019-04-15 |
| 1073088316 | Marshall Medical Center | Psychiatry & Neurology | 1045 Marshall Way, Placerville, CA 95667-5721 | 2018-10-12 |
| 1386065480 | Marshall Medical Center | Pediatrics | 4341 Golden Center Dr, Suite A, Placerville, CA 95667-6260 | 2013-12-17 |
| 1558645820 | Marshall Medical Center | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2011-10-05 |
| 1649562315 | Marshall Medical Center | Orthopaedic Surgery | 4300 Golden Center Dr, Suite C, Placerville, CA 95667-6278 | 2011-05-12 |
| 1578872784 | Marshall Medical Center | Otolaryngology | 4300 Golden Center Dr, Suite D, Placerville, CA 95667-6278 | 2010-10-05 |
| 1326286048 | Marshall Medical Center | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2009-02-03 |
| 1215181664 | Marshall Medical Center | Urology | 1004 Fowler Way, Suite 4, Placerville, CA 95667-5746 | 2008-11-12 |
| 1659554285 | Marshall Medical Center | Internal Medicine | 3581 Palmer Dr, Suite 400, Cameron Park, CA 95682-8236 | 2007-12-05 |
| 1609062389 | Marshall Medical Center | Obstetrics & Gynecology | 1095 Marshall Way, Suite 201, Placerville, CA 95667-5722 | 2007-09-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MARSHALL MEDICAL CENTER FAMILY | 1600 Medical Center Dr Ste 1400, Huntington, WV 25701-3657 |
| Street Address |
6065 STATE HWY 193 |
| City | GEORGETOWN |
| State | CA |
| Zip Code | 95634-9623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912023318 | Kenneth F. Hajek | Dentist | 2774 Miners Flat Rd, Georgetown, CA 95634 | 2007-03-21 |
| 1487711560 | Black Oak Mine Unified School District | Local Education Agency (LEA) | 6540 Wentworth Springs Rd, Georgetown, CA 95634 | 2007-01-02 |
| 1134189368 | Alan E Lubanes | Optometrist | 6325 Hwy 193, Georgetown, CA 95634 | 2006-03-23 |
| 1982689626 | Gregory L Dales | Registered Nurse | 6065 Highway 193, Georgetown, CA 95634 | 2005-12-14 |
| 1861487746 | Jacqueline Percy | Emergency Medicine | Bitburg Hospital, Bitburg Air Base, BITBURG 95634 | 2005-09-16 |
| 1265975148 | Daisy Klith | Family Medicine | 6065 Highway 193, Georgetown, CA 95634 | 2016-11-28 |
| 1972675411 | William Garland Windle | Dentist | 2774 Miners Flat Rd., Georgetown, CA 95634-1706 | 2006-11-13 |
| 1588797450 | Keith P Harston | Chiropractor | 2776 Miners Flat Road, Georgetown, CA 95634-1855 | 2007-03-13 |
| 1275789562 | Mark Lowell Greenmun | Dentist | 2774 Miners Flat Rd, Georgetown, CA 95634-9345 | 2008-08-18 |
| 1619004710 | Leslie Tucker Smith | Marriage & Family Therapist | 6087 Front St, Suite 2, Georgetown, CA 95634-9358 | 2007-02-27 |
| Find all providers in zip 95634 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598818098 | Georgetown Health Group | Clinic/Center | 1530 High Market St, Georgetown, SC 29440 | 2007-01-19 |
| 1629628920 | Adams County Regional Medical Center | Clinic/Center | 900 Mount Orab Pike, Georgetown, OH 45121-8815 | 2019-09-18 |
| 1972158475 | Baptist Health Medical Group Inc | Clinic/Center | 210 Bevins Ln, Georgetown, KY 40324-6120 | 2019-08-02 |
| 1013334200 | Georgetown Pediatric Center | Clinic/Center | 57 Jessamine Ave, Georgetown, SC 29440-5837 | 2014-03-25 |
| 1669654224 | Family Practice Medical Center Ltd | Clinic/Center | 302 N Main St, Georgetown, IL 61846-1728 | 2007-12-05 |
| 1841364007 | Georgetown Physician Associates, LLC | Clinic/Center | 1075 N Fraser St, Georgetown, SC 29440-2848 | 2006-11-20 |
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| Find all providers with the same taxonomy | ||||
| City | GEORGETOWN |
| Zip Code | 95634 |
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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.