Healthcare Provider Details

I. General information

NPI: 1457414799
Provider Name (Legal Business Name): GRANT CO PUBLIC HOSPITAL DISTRICT 3
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 NAT WASHINGTON WAY
EPHRATA WA
98823-1982
US

IV. Provider business mailing address

220 NAT WASHINGTON WAY
EPHRATA WA
98823-1982
US

V. Phone/Fax

Practice location:
  • Phone: 509-754-3330
  • Fax: 509-754-2351
Mailing address:
  • Phone: 509-754-3330
  • Fax: 509-754-2351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: ROSALINDA KIBBY
Title or Position: EXECUTIVE ASSISTANT
Credential: CPCS
Phone: 509-754-4631