Provider Demographics
NPI:1922198712
Name:NORTHERN INYO HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:NORTHERN INYO HEALTHCARE DISTRICT
Other - Org Name:NORTHERN INYO HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-873-2838
Mailing Address - Street 1:150 PIONEER LN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2556
Mailing Address - Country:US
Mailing Address - Phone:760-873-5811
Mailing Address - Fax:760-872-5800
Practice Address - Street 1:150 PIONEER LN
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2556
Practice Address - Country:US
Practice Address - Phone:760-873-5811
Practice Address - Fax:760-872-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000179282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT40015FMedicaid
CAZZT30015FMedicaid
CA1278460001Medicare NSC
CAZZZ92754ZMedicare PIN
CAZZT40015FMedicaid
CA051324Medicare Oscar/Certification
CAZZZ27544ZMedicare PIN
CAZZZ92755ZMedicare PIN