Healthcare Provider Details
I. General information
NPI: 1801831227
Provider Name (Legal Business Name): COUNTY OF TULARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2006
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
660 E VISALIA RD
FARMERSVILLE CA
93223-1641
US
IV. Provider business mailing address
5957 S MOONEY BLVD
VISALIA CA
93277-9394
US
V. Phone/Fax
- Phone: 559-713-2890
- Fax: 559-594-6790
- Phone: 559-624-8000
- Fax: 559-737-4697
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHERYL
L
DUERKSEN
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 559-624-8000