Healthcare Provider Details

I. General information

NPI: 1811979610
Provider Name (Legal Business Name): GRANT COUNTY PUBLIC HOSPITAL DISTRICT NO. 3
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NAT WASHINGTON WAY
EPHRATA WA
98823-1997
US

IV. Provider business mailing address

200 NAT WASHINGTON WAY
EPHRATA WA
98823-1997
US

V. Phone/Fax

Practice location:
  • Phone: 509-754-4631
  • Fax: 509-754-6356
Mailing address:
  • Phone: 509-754-4631
  • Fax: 509-754-6356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH045
License Number StateWA

VIII. Authorized Official

Name: CHERYL A BODI
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 509-717-5206