Provider Demographics
NPI:1699859223
Name:KERN COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:KERN COUNTY HOSPITAL AUTHORITY
Other - Org Name:KERN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-326-2104
Mailing Address - Street 1:1111 COLUMBUS ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-1938
Mailing Address - Country:US
Mailing Address - Phone:661-326-6580
Mailing Address - Fax:661-326-6582
Practice Address - Street 1:1111 COLUMBUS ST STE 2000
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-1938
Practice Address - Country:US
Practice Address - Phone:661-326-6580
Practice Address - Fax:661-326-6582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHE40876333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHE408760Medicaid