Provider Demographics
NPI:1538141627
Name:HANFORD COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HANFORD COMMUNITY HOSPITAL
Other - Org Name:ADVENTIST HEALTH HANFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-537-0050
Mailing Address - Street 1:PO BOX 888799
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8799
Mailing Address - Country:US
Mailing Address - Phone:559-537-0050
Mailing Address - Fax:559-585-7243
Practice Address - Street 1:115 MALL DR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5786
Practice Address - Country:US
Practice Address - Phone:559-582-9000
Practice Address - Fax:559-537-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000102282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT30121FMedicaid
CAZZT30121FMedicaid