Provider Demographics
NPI:1336167550
Name:REEDLEY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:REEDLEY COMMUNITY HOSPITAL
Other - Org Name:ADVENTIST HEALTH REEDLEY
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 888806
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8806
Mailing Address - Country:US
Mailing Address - Phone:559-638-8155
Mailing Address - Fax:559-637-7555
Practice Address - Street 1:372 W. CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2113
Practice Address - Country:US
Practice Address - Phone:559-638-8155
Practice Address - Fax:559-637-7555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH SYSTEM/WEST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40000149282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACGP168088Medicaid
CAZZR00192FMedicaid
CAIP-ZZR00192FOtherMEDICAL INPATIENT
CAZZZ92646ZOtherPROFESSIONAL FEES
CAHSP40192FMedicaid
CAOP-HSP40192FOtherMEDI-CAL OUTPATIENT
CAZZZC1008ZOtherBLUE SHIELD PROVIDER NO
CAHAP18540FMedicaid
CAZZR00192FMedicaid
CACGP168088Medicaid
CAZZR00192FMedicaid
CACGP168088Medicaid