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CAH051324-01 NORTHERN INYO HOSPITAL (Active)
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Main Details
Name
NORTHERN INYO HOSPITAL
Subdivision Name
Northern Inyo Hospital Rural Health Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH051324-01
Medicare Provider Number
051324
Outpatient Facility Provider Number
058578
Additional Details
Current Program Status
Active
Registration Date
2/9/2012
Participating Start Date
4/1/2012
Participating Approval Date
3/15/2012
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Northern Inyo Healthcare District
Christian Wallis, CEO
(224) 358-6633
Primary Contact
Northern Inyo Healthcare District
Jeff Kneip, Pharmacy Director
(760) 873-2111 Ext: 2046
Addresses
Street Address
153-B Pioneer Lane
Bishop, CA 93514
Billing Address
Northern Inyo Healthcare District
150 Pioneer Lane
Bishop, CA 93514
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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