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General NPI Number Information
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NPI Number | 1881232676
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Entity Type | Organization
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Legal Business Name | MADERA COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 121 BELMONT AVE., SUITE 101
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City | MENDOTA
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State | CA
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Zip | 93640
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Country | US
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Telephone | 559-675-5505
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Fax | 559-675-5509
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Provider Business Mailing Address
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Address Line | 1250 E ALMOND AVE
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City | MADERA
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State | CA
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Zip | 93637-5696
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Country | US
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Telephone | 559-675-5505
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Fax | 559-675-5509
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Authorized Official
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Title or Position | VP-FINANCE/CFO
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Name | MR. MARK JAMES FOOTE
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Credential |
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Telephone | 559-675-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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