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Organization
COUNTRY HILLS HEALTH CARE INCORPORATED
Active
Organization
COUNTRY HILLS HEALTH CARE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CAROL J PATTEN (ACCOUNTS RECEIVABLE SUPERVISOR)
(619) 441-8745
Entity
Organization
Contact information
Practice address
1580 BROADWAY, EL CAJON, CA 92021-5124
(619) 441-8745
(619) 334-3248
Mailing address
1580 BROADWAY, EL CAJON, CA 92021-5124
(619) 441-8745
(619) 334-3248
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
08000361
CA
332BN1400X
Nursing Facility Supplies (DME)
—
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMCSUB0TC
MEDICAL INTERNET USER ID
CA
05
—
LTC55431G
—
CA
Enumeration date
10/09/2006
Last updated
12/20/2013
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