Healthcare Provider Details

I. General information

NPI: 1093732554
Provider Name (Legal Business Name): REEDLEY COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S LEON S PETERS BLVD
FOWLER CA
93625-2439
US

IV. Provider business mailing address

PO BOX 888806
LOS ANGELES CA
90088-8806
US

V. Phone/Fax

Practice location:
  • Phone: 559-834-1614
  • Fax: 559-834-0015
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number040000140
License Number StateCA

VIII. Authorized Official

Name: ANDREA KOFL
Title or Position: CENTRAL VALLEY NETWORK PRESIDENT
Credential:
Phone: 559-537-0056