Provider Demographics
NPI:1689037533
Name:REEDLEY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:REEDLEY COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CENTRAL VALLEY NETWORK PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOFL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-537-0056
Mailing Address - Street 1:PO BOX 888806
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8806
Mailing Address - Country:US
Mailing Address - Phone:661-746-5788
Mailing Address - Fax:661-746-5273
Practice Address - Street 1:406 JAMES ST
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263-2035
Practice Address - Country:US
Practice Address - Phone:661-746-5788
Practice Address - Fax:661-746-5273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058691Medicare Oscar/Certification
CA058691Medicare PIN