Provider Demographics
NPI:1043203276
Name:MAYERS MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MAYERS MEMORIAL HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:M
Authorized Official - Last Name:REES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-336-5511
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER MILLS
Mailing Address - State:CA
Mailing Address - Zip Code:96028
Mailing Address - Country:US
Mailing Address - Phone:530-336-5511
Mailing Address - Fax:530-336-6199
Practice Address - Street 1:43563 STATE HIGHWAY 299 E
Practice Address - Street 2:
Practice Address - City:FALL RIVER MILLS
Practice Address - State:CA
Practice Address - Zip Code:96028-9787
Practice Address - Country:US
Practice Address - Phone:530-336-5511
Practice Address - Fax:530-336-6996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230000021282N00000X
CAHPE30724333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HSP40406GOtherMEDI-CAL
CAPHB307210Medicaid
LTC06416FOtherMEDI-CAL
CAZZR00406GMedicaid
HSP40406GOtherMEDI-CAL
051305Medicare ID - Type Unspecified
051738Medicare ID - Type Unspecified
057281Medicare ID - Type Unspecified
05Z305Medicare ID - Type Unspecified