Healthcare Provider Details

I. General information

NPI: 1588992978
Provider Name (Legal Business Name): SOUTHERN INYO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E. LOCUST ST.
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 TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LEE ONA BARRON
Title or Position: CEO
Credential:
Phone: 760-876-5501