Provider Demographics
NPI:1487669032
Name:LAST FRONTIER HEALTHCARE DISTRICT
Entity type:Organization
Organization Name:LAST FRONTIER HEALTHCARE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-708-8801
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:ALTURAS
Mailing Address - State:CA
Mailing Address - Zip Code:96101-0190
Mailing Address - Country:US
Mailing Address - Phone:530-708-8800
Mailing Address - Fax:530-233-6609
Practice Address - Street 1:1111 N NAGLE ST
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-3840
Practice Address - Country:US
Practice Address - Phone:530-708-8800
Practice Address - Fax:530-233-6609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05Z330275N00000X
CA230000026282NR1301X
CA051330282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ93343ZMedicare PIN
CA050430Medicare Oscar/Certification
CAZZZ93342ZMedicare PIN
CA051330Medicare Oscar/Certification
CA05Z330Medicare Oscar/Certification