Organization
KERN VALLEY HEALTHCARE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE OLSON (BUSINESS OFFICE MANAGER)
(760) 379-2681
Entity
Organization
Contact information
Practice address
6412 LAUREL AVE, LAKE ISABELLA, CA 93240-9529
(760) 379-2681
(760) 379-4795
Mailing address
PO BOX 1628, LAKE ISABELLA, CA 93240-1628
(760) 379-2681
(760) 379-4795
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
120000183
CA
314000000X
Skilled Nursing Facility
120000183
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PHE40272
CA
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0503830
OTHER ID NUMBER
—
05
—
BCP08561F
—
CA
05
—
GR0094370
—
CA
05
—
HAP08561F
—
CA
05
—
LTC30542F
—
CA
05
—
LTC55517F
—
CA
05
—
PHA402720
—
CA
05
—
RHM08527F
—
CA
05
—
RHM08561F
—
CA
05
—
ZZT30542F
—
CA
05
—
ZZT40542F
—
CA
Enumeration date
11/03/2005
Last updated
07/15/2014
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