Healthcare Provider Details

I. General information

NPI: 1831128602
Provider Name (Legal Business Name): SOUTHERN INYO HEALTHCARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E. LOCUST STREET
LONE PINE CA
93545
US

IV. Provider business mailing address

PO BOX 1009
LONE PINE CA
93545-1009
US

V. Phone/Fax

Practice location:
  • Phone: 760-876-5501
  • Fax: 760-876-4388
Mailing address:
  • Phone: 760-876-5501
  • Fax: 760-876-4388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number240000205
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number240000205
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number240000205
License Number StateCA

VIII. Authorized Official

Name: PETER SPIERS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 760-876-5501