Provider Demographics
NPI:1225038953
Name:PARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER
Entity Type:Organization
Organization Name:PARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:L
Authorized Official - Last Name:DRUMWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-352-5400
Mailing Address - Street 1:3865 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3919
Mailing Address - Country:US
Mailing Address - Phone:951-352-5400
Mailing Address - Fax:951-352-5427
Practice Address - Street 1:3865 JACKSON ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3919
Practice Address - Country:US
Practice Address - Phone:951-352-5400
Practice Address - Fax:951-352-5427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25000186282N00000X
CA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT30102FOtherMEDICAL
CAHSC30102FMedicaid
CAZZT40102FOtherMEDICAL OUTPATIENT
CAHSC30102FMedicaid