1760718100 NPI number — COUNTY OF LINCOLN

Table of content: (NPI 1760718100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760718100 NPI number — COUNTY OF LINCOLN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF LINCOLN
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:
LINCOLN COUNTY HEALTH & HUMAN SERVICES
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:
1760718100
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 SW NYE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97365-3821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-265-0468
Provider Business Mailing Address Fax Number:
541-265-0443

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 S CRESTLINE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALDPORT
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97394-9739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-265-0471
Provider Business Practice Location Address Fax Number:
541-650-5662
Provider Enumeration Date:
10/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
VALERIE
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
INTERIM DIRECTOR
Authorized Official Telephone Number:
541-265-0434

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 213144 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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