Basic Information
| Provider Information | |||||||||
| NPI: | 1912125667 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MAYERS MEMORIAL HOSPITAL DISTRICT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 459 | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER MILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960280459 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 43563 HIGHWAY 299 EAST | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER MILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 96028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303365511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2007 | ||||||||
| LastUpdateDate: | 01/08/2016 | ||||||||
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| AuthorizedOfficialLastName: | LAKEY | ||||||||
| AuthorizedOfficialFirstName: | TRAVIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5303365511 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | ZZR00406G | 05 | CA | MEDICAID | HPC01738F | 05 | CA | MEDICAID |