Provider Demographics
NPI:1427001346
Name:RIOS & PIERCE MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RIOS & PIERCE MEDICAL CORPORATION
Other - Org Name:MEDICOS UNIDOS DE AVENAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLPHUS
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:II
Authorized Official - Credentials:D C
Authorized Official - Phone:559-905-9000
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-0530
Mailing Address - Country:US
Mailing Address - Phone:559-386-9000
Mailing Address - Fax:559-383-9090
Practice Address - Street 1:148 E KINGS ST
Practice Address - Street 2:
Practice Address - City:AVENAL
Practice Address - State:CA
Practice Address - Zip Code:93204-1529
Practice Address - Country:US
Practice Address - Phone:559-386-9000
Practice Address - Fax:559-386-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM08616FMedicaid
CAHAP08616FOtherFAMILY PACT
CARHM08616FMedicaid