Provider Demographics
NPI:1982680138
Name:HANFORD COMMUNITY MEDICAL CENTER
Entity Type:Organization
Organization Name:HANFORD COMMUNITY MEDICAL CENTER
Other - Org Name:DBA ADVENTIST HEALTH HOME CARE AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-582-9000
Mailing Address - Street 1:460 KINGS COUNTY DR
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5953
Mailing Address - Country:US
Mailing Address - Phone:559-585-3425
Mailing Address - Fax:559-585-3420
Practice Address - Street 1:460 KINGS COUNTY DR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5953
Practice Address - Country:US
Practice Address - Phone:559-585-3425
Practice Address - Fax:559-585-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01670FMedicaid
CA051670Medicare ID - Type Unspecified