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General NPI Number Information
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NPI Number | 1609112739
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Entity Type | Organization
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Legal Business Name | GRANT COUNTY PUBLIC HOSPITAL DISTRICT 1
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 8420 ASPI BLVD
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City | MOSES LAKE
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State | WA
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Zip | 98837-1820
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Country | US
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Telephone | 509-793-9781
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Fax | 509-764-3244
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Provider Business Mailing Address
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Address Line | 660 S COOLIDGE ST
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City | MOSES LAKE
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State | WA
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Zip | 98837-1872
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Country | US
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Telephone | 509-793-9715
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Fax | 509-764-3244
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Authorized Official
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Title or Position | CFO SAMARITAN HOSPITAL
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Name | THERESA SULLIVAN
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Credential |
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Telephone | 509-793-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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