Provider Demographics
NPI:1265646152
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:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-336-5511
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:43563 STATE HIGHWAY 299 EAST
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 EAST
Practice Address - Street 2:
Practice Address - City:FALL RIVER MILLS
Practice Address - State:CA
Practice Address - Zip Code:96028
Practice Address - Country:US
Practice Address - Phone:530-336-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHB307240OtherMEDI-CAL