Healthcare Provider Details

I. General information

NPI: 1497755334
Provider Name (Legal Business Name): AVENAL HEALTHCARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E ALPINE ST
AVENAL CA
93204-1019
US

IV. Provider business mailing address

PO BOX 269110
SACRAMENTO CA
95826-9110
US

V. Phone/Fax

Practice location:
  • Phone: 559-386-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: KEN BROWN
Title or Position: BOARD CHAIRMAN
Credential:
Phone: 559-386-2211