South Fork Healthcare, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SOUTH FORK HEALTHCARE, LLC

Doing business as

Dba Serrano South Conv Hospital

Practice address

5400 Fountain Ave
Los Angeles, CA 90029-1007

Phone

(323) 461-4301

Fax

(323) 461-2784

NPI assigned

Jul 6, 2006

Last updated

Aug 12, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sheilah Grier

Title

Ar Director

Phone

(323) 461-4301

Specialties & licenses 1

Addresses

Other names 1

• DBA SERRANO SOUTH CONV HOSPITAL Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1801827738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291007",
            "telephone_number": "323-461-4301",
            "fax_number": "323-461-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291007",
            "telephone_number": "323-461-4301",
            "fax_number": "323-461-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FORK HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "GRIER",
        "authorized_official_first_name": "SHEILAH",
        "authorized_official_title_or_position": "AR DIRECTOR",
        "authorized_official_telephone_number": "323-461-4301"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA SERRANO SOUTH CONV HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• South Healthcare Center LLC (Country Villa South Healthcare Center)
• South la Eye Clinic
• South Los Angeles Medical Group Professional Corporation
• South Oc Open Arms
• South Western Pharmacy

• Skilled Nursing Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.