Healthcare Provider Details

I. General information

NPI: 1609180728
Provider Name (Legal Business Name): SOUTHERN INYO HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E LOCUST ST
LONE PINE CA
93545-1009
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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MRS. VICKIE J TORIX
Title or Position: MEDICAL RECORDS MANAGER
Credential:
Phone: 760-876-5501