Provider Demographics
NPI:1023129459
Name:STRATHMORE MEDICAL CORPORATION
Entity type:Organization
Organization Name:STRATHMORE MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOLPHUS
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:559-905-9000
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-0398
Mailing Address - Country:US
Mailing Address - Phone:559-568-1200
Mailing Address - Fax:559-568-1206
Practice Address - Street 1:19757 ORANGE BELT DR
Practice Address - Street 2:
Practice Address - City:STRATHMORE
Practice Address - State:CA
Practice Address - Zip Code:93267-9798
Practice Address - Country:US
Practice Address - Phone:559-568-1200
Practice Address - Fax:559-568-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHM08914F261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP08914FOtherFAMILY PACT
CARHM08914FMedicaid
CARHM08914FMedicaid