Provider Demographics
NPI:1760995625
Name:PIONEERS MEMORIAL HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:PIONEERS MEMORIAL HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-351-3597
Mailing Address - Street 1:565 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-2423
Mailing Address - Country:US
Mailing Address - Phone:760-344-5565
Mailing Address - Fax:
Practice Address - Street 1:565 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2423
Practice Address - Country:US
Practice Address - Phone:760-344-5565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIONEERS MEMORIAL HEALTHCARE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090000087282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural