| Organization Name: | COPPERTOWER FAMILY MEDICAL CENTER |
| NPI Number: | 1033534466 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENINE ROSE SAUNDERS (CFO) |
| Mailing Address: | 6 Tarman Dr Cloverdale |
| State: | CA US |
| Postal Code: | 954253932 |
| Phone Number: | 7078944229 |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2014 |
| NPI Last Update Date: | 12/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 110000318 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |