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COUNTRY HILLS HEALTH CARE INCORPORATED
Nursing Facility Supplies >> Durable Medical Equipment & Medical Supplies >> SuppliersRegistrant NPI Number: 1700973963
Organizational Registrant:Organization Name: COUNTRY HILLS HEALTH CARE INCORPORATED
Organization is not Subpart
Authorized Official: CAROL J PATTEN ACCOUNTS RECEIVABLE SUPERVISOR 619--44-18745
Organization is not Subpart
Authorized Official: CAROL J PATTEN ACCOUNTS RECEIVABLE SUPERVISOR 619--44-18745
Location and contact information for practice:
1580 BROADWAY EL CAJON, CA 92021-5124 US
Tel: 619-441-8745 Fax: 619-334-3248
Tel: 619-441-8745 Fax: 619-334-3248
Contact information for business:
1580 BROADWAY EL CAJON, CA 92021-5124 US
Tel: 619-441-8745 Fax: 619-334-3248
Tel: 619-441-8745 Fax: 619-334-3248
Registration Information:
NPI: 1700973963
Entity Type: Organization
Entity Type: Organization
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 332BN1400X | Suppliers Durable Medical Equipment & Medical Supplies Nursing Facility Supplies | CA | |
| N | 332BP3500X | Suppliers Durable Medical Equipment & Medical Supplies | CA | |
| Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | CA | 08000361 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MEDICAL INTERNET USER ID | CMCSUB0TC | CA | 01 |
| LTC55431G | CA | 05 |
