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General NPI Number Information
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NPI Number | 1518378884
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Entity Type | Organization
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Legal Business Name | KVH
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 310 S ROOSEVELT AVE
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City | GOLDENDALE
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State | WA
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Zip | 98620-9201
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Country | US
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Telephone | 509-773-4020
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Fax |
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Provider Business Mailing Address
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Address Line | 310 S ROOSEVELT AVE
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City | GOLDENDALE
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State | WA
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Zip | 98620-9201
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Country | US
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Telephone | 509-773-4020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LESLIE HEBERT
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Credential | CEO
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Telephone | 509-773-4020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | RN00065003
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | AP30001359
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License Number State | WA
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