Provider Demographics
NPI:1154772705
Name:FAMILY HEALTHCARE NETWORK
Entity type:Organization
Organization Name:FAMILY HEALTHCARE NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HYDASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-737-4700
Mailing Address - Street 1:305 E CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-737-4700
Mailing Address - Fax:559-734-1247
Practice Address - Street 1:12586 AVENUE 408
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-9454
Practice Address - Country:US
Practice Address - Phone:559-741-2650
Practice Address - Fax:559-741-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 333600000X
CA525743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160790OtherPK