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GREATER FRESNO HEALTH ORGANIZATION INC. NPI 1265521488


NPI Information

NPI: 1265521488
Provider Name: GREATER FRESNO HEALTH ORGANIZATION, INC.

Doing Business As: KINGS WINERY MEDICAL CLINIC

Classification: Exclusive Provider Organization - 302F00000X
Entity Type: Organization

CLIA Number: 05D0715734

Address:
4929 E KINGS CANYON RD
FRESNO, CA
ZIP 93727
Phone: (559) 255-6476
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GREATER FRESNO HEALTH ORGANIZATION, INC. is an exclusive provider organization in Fresno, CA. The provider is (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. GREATER FRESNO HEALTH ORGANIZATION, INC. NPI is 1265521488. The provider is registered as an organization entity type.
The provider Is Doing Business As Kings Winery Medical Clinic.

The provider's business location address is:

4929 E KINGS CANYON RD
FRESNO, CA
ZIP 93727-812
Phone: (559) 255-6476
Fax: (559) 255-7906

The provider's authorized official is Bobby Bliatout .
The authorized official title is Ceo and has the following contact phone number (559) 255-6476.

The CLIA number assigned to this NPI record is 05D0715734 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/12/2006 and was last updated on 12/6/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1302F00000XExclusive Provider Organization04000036CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1FHC70517FMEDICAIDCALIFORNIA
2051977MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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