Healthcare Provider Details

I. General information

NPI: 1225172398
Provider Name (Legal Business Name): REDLANDS COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

IV. Provider business mailing address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-5501
  • Fax: 909-335-6494
Mailing address:
  • Phone: 909-335-5501
  • Fax: 909-335-6494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number240000191
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MOK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 909-335-5501