Healthcare Provider Details

I. General information

NPI: 1508869074
Provider Name (Legal Business Name): COUNTY OF CURRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29984 ELLENSBURG
GOLD BEACH OR
97444
US

IV. Provider business mailing address

PO BOX 493
GOLD BEACH OR
97444-0493
US

V. Phone/Fax

Practice location:
  • Phone: 541-247-7084
  • Fax: 541-247-2117
Mailing address:
  • Phone: 541-247-7084
  • Fax: 541-247-2117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number381534
License Number StateOR

VIII. Authorized Official

Name: MRS. LORI KENT
Title or Position: DIRECTOR
Credential: RN CHPN
Phone: 541-247-7084