1285742338 NPI number — HARNEY DISTRICT HOSPITAL

Table of content: (NPI 1285742338)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285742338 NPI number — HARNEY DISTRICT HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARNEY DISTRICT HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285742338
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
557 W WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURNS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97720-1441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-573-7281
Provider Business Mailing Address Fax Number:
541-573-8627

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
557 W WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURNS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97720-1441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-573-7281
Provider Business Practice Location Address Fax Number:
541-573-8627
Provider Enumeration Date:
08/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
541-573-7281

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  14 0704 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 800594 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 903353 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 026053 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 092502 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 934069 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95017075 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: GA557OR , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: HS003OP , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3780020947 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 419900 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 190265 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 226328 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 903049200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: HS003IP , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003430200 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: HA312906 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP30724 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP40724 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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