Provider Demographics
NPI:1609180728
Name:SOUTHERN INYO HOSPITAL
Entity Type:Organization
Organization Name:SOUTHERN INYO HOSPITAL
Other - Org Name:HOSPICE OF INYO COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL RECORDS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TORIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-876-5501
Mailing Address - Street 1:PO BOX 1009
Mailing Address - Street 2:
Mailing Address - City:LONE PINE
Mailing Address - State:CA
Mailing Address - Zip Code:93545-1009
Mailing Address - Country:US
Mailing Address - Phone:760-876-5501
Mailing Address - Fax:760-876-4388
Practice Address - Street 1:501 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:LONE PINE
Practice Address - State:CA
Practice Address - Zip Code:93545-1009
Practice Address - Country:US
Practice Address - Phone:760-876-5501
Practice Address - Fax:760-876-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZT403884Medicaid
CA051302Medicare Oscar/Certification
CAZZZT403884Medicaid
CA555527Medicare Oscar/Certification