Healthcare Provider Details

I. General information

NPI: 1104666064
Provider Name (Legal Business Name): ONE COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 WEBBER ST
THE DALLES OR
97058-3749
US

IV. Provider business mailing address

849 PACIFIC AVE
HOOD RIVER OR
97031-1956
US

V. Phone/Fax

Practice location:
  • Phone: 541-296-4610
  • Fax:
Mailing address:
  • Phone: 541-386-6380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RENEROSE HINKLE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 541-256-4404