MEDICARE: REEDLEY COMMUNITY HOSPITAL

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
1	261QR1300X	Rural Health Clinic/Center	040000140	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1699758003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REEDLEY COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 888806
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90088-8806
Country	:	US
Telephone Number	:	559-587-4349
Fax Number	:	559-587-4366

Provider Business Practice Location Address
First Line	:	810 E D ST
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-9545
Country	:	US
Telephone Number	:	559-587-4349
Fax Number	:

Authorized Official
Title or Position	:	CENTRAL VALLEY NETWORK PRESIDENT
Name	:	ANDREA KOFL
Credential	:
Telephone Number	:	559-537-0056

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	04/08/2022

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Directions to “REEDLEY COMMUNITY HOSPITAL ” Practice Location

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