1417087297 NPI number — MALHEUR COUNTY

Table of content: (NPI 1417087297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417087297 NPI number — MALHEUR COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MALHEUR COUNTY
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:
MALHEUR COUNTY HEALTH DEPT
Provider Other Organization Name Type Code:
3
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:
1417087297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1108 S.W. 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ONTARIO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-889-7279
Provider Business Mailing Address Fax Number:
541-889-8468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1108 S.W. 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ONTARIO
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-889-7279
Provider Business Practice Location Address Fax Number:
541-889-8468
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
POE
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
541-889-7279

Provider Taxonomy Codes

  • Taxonomy code: 261QA0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0005X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP0905X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 097204 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 320085 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 043344 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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