Healthcare Provider Details

I. General information

NPI: 1386774222
Provider Name (Legal Business Name): GARFIELD COUNTY HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SOUTH 10TH STREET
POMEROY WA
99347
US

IV. Provider business mailing address

PO BOX 130
POMEROY WA
99347-0130
US

V. Phone/Fax

Practice location:
  • Phone: 509-843-3412
  • Fax:
Mailing address:
  • Phone: 509-843-3412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberMD00025084
License Number StateWA

VIII. Authorized Official

Name: LETA A TRAVIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 509-843-3412