Provider Demographics
NPI:1801366711
Name:ADVENTIST HEALTH TULARE
Entity Type:Organization
Organization Name:ADVENTIST HEALTH TULARE
Other - Org Name:TULARE REGIONAL MEDICAL CENTER
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 889190
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-9190
Mailing Address - Country:US
Mailing Address - Phone:559-688-0821
Mailing Address - Fax:
Practice Address - Street 1:869 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2207
Practice Address - Country:US
Practice Address - Phone:559-688-0821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherAETNA
PENDINGOtherHEALTH NET
PENDINGOtherBLUE CROSS
PENDINGOtherBLUE SHIELD
CAPENDINGMedicaid