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NPI Code Detail

MEDICARE: FAMILY HEALTHCARE NETWORK

MEDICARE: FAMILY HEALTHCARE NETWORK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2261QF0400XFederally Qualified Health Center (FQHC)120000590CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083611156
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY HEALTHCARE NETWORK
Provider Business Mailing Address
First Line : 305 E CENTER AVE
Second Line :
City : VISALIA
State : CA
Zip : 93291-6331
Country : US
Telephone Number : 559-737-4700
Fax Number : 559-734-1247
Provider Business Practice Location Address
First Line : 1107 W POPLAR AVE
Second Line :
City : PORTERVILLE
State : CA
Zip : 93257-5839
Country : US
Telephone Number : 559-781-7242
Fax Number : 559-782-8259
Authorized Official
Title or Position : PRESIDENT CEO
Name : MRS. KERRY HYDASH
Credential :
Telephone Number : 559-737-4731
Provider Enumeration Date : 07/05/2005
Last Update Date : 04/26/2022

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Directions to “FAMILY HEALTHCARE NETWORK ” Practice Location

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