Provider Demographics
NPI:1942298153
Name:HAYWARD SISTERS HOSPITAL
Entity Type:Organization
Organization Name:HAYWARD SISTERS HOSPITAL
Other - Org Name:ST. ROSE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEX
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-264-4002
Mailing Address - Street 1:27200 CALAROGA AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4383
Mailing Address - Country:US
Mailing Address - Phone:510-264-4002
Mailing Address - Fax:510-887-7421
Practice Address - Street 1:27200 CALAROGA AVENUE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4339
Practice Address - Country:US
Practice Address - Phone:510-264-4002
Practice Address - Fax:510-887-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000107282N00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR00002FMedicaid
CAHSP40002FMedicaid
CAHSC00002FMedicaid
CAZZZ92818ZOtherPTAN NUMBER FOR MEDICARE 1500 CLAIM FORM BILLING
CA050002Medicare Oscar/Certification
CAHSC00002FMedicaid