Healthcare Provider Details

I. General information

NPI: 1982938619
Provider Name (Legal Business Name): PACIFIC COUNTY HOSPITAL DISTRICT 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ALDER ST
SOUTH BEND WA
98586-0438
US

IV. Provider business mailing address

800 ALDER ST PO BOX 438
SOUTH BEND WA
98586-0438
US

V. Phone/Fax

Practice location:
  • Phone: 360-875-5526
  • Fax: 360-875-6167
Mailing address:
  • Phone: 360-875-5526
  • Fax: 360-875-6167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: TERRY STONE
Title or Position: ASSISTANT ADMINISTRATION/ CFO
Credential:
Phone: 360-875-4566