Provider Demographics
NPI:1912125667
Name:MAYERS MEMORIAL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MAYERS MEMORIAL HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-336-5511
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER MILLS
Mailing Address - State:CA
Mailing Address - Zip Code:96028-0459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43563 HIGHWAY 299 EAST
Practice Address - Street 2:
Practice Address - City:FALL RIVER MILLS
Practice Address - State:CA
Practice Address - Zip Code:96028
Practice Address - Country:US
Practice Address - Phone:530-336-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR00406GMedicaid
CAHPC01738FMedicaid
CAHSP40406GMedicare Oscar/Certification
CAZZZ92669ZMedicare Oscar/Certification
CAZZZ25351ZMedicare Oscar/Certification
CA051738Medicare Oscar/Certification
CAZZZ17446ZMedicare Oscar/Certification
CAZZZC4503ZMedicare Oscar/Certification
CA051305Medicare Oscar/Certification
CAHPC01738FMedicaid