Healthcare Provider Details

I. General information

NPI: 1730293820
Provider Name (Legal Business Name): EWCH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 WEST ST
HAYWARD CA
94545-1932
US

IV. Provider business mailing address

1805 WEST ST
HAYWARD CA
94545-1932
US

V. Phone/Fax

Practice location:
  • Phone: 510-783-4811
  • Fax: 510-783-4062
Mailing address:
  • Phone: 510-783-4811
  • Fax: 510-783-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. JACK EDWARD EASTERDAY
Title or Position: PRESIDENT
Credential:
Phone: 510-995-5300