GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1 NPI 1619086766

NPI Information

NPI: 1619086766
Provider Name: GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1

Doing Business As: SAMARITAN CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1550 S PIONEER WAY STE 115
MOSES LAKE, WA
ZIP 98837
Phone: (509) 793-9713
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GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1 is a rural health clinic center in Moses Lake, WA. GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1 NPI is 1619086766. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Samaritan Clinic.

The provider's business location address is:

1550 S PIONEER WAY STE 115
MOSES LAKE, WA
ZIP 98837-618
Phone: (509) 793-9713
Fax: (509) 764-3244

The provider's authorized official is Theresa Sullivan .
The authorized official title is Ceo and has the following contact phone number (509) 793-9710.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 12/28/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QR1300X	Clinic/Center	Rural Health			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	7063415	MEDICAID	WASHINGTON
2	7109929	MEDICAID	WASHINGTON
3	1014658	MEDICAID	WASHINGTON

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

NPI Synchronization or Removal

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