Provider Demographics
NPI:1225411747
Name:EAST VALLEY FAMILY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:EAST VALLEY FAMILY HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEPGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-260-3438
Mailing Address - Street 1:12683 AVENUE 416
Mailing Address - Street 2:
Mailing Address - City:OROSI
Mailing Address - State:CA
Mailing Address - Zip Code:93647-2017
Mailing Address - Country:US
Mailing Address - Phone:559-528-4717
Mailing Address - Fax:559-528-0302
Practice Address - Street 1:12683 AVENUE 416
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-2017
Practice Address - Country:US
Practice Address - Phone:559-528-4717
Practice Address - Fax:559-528-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health