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NPI Code Detail

MEDICARE: GRAYS HARBOR COMMUNITY HOSPITAL

MEDICARE: GRAYS HARBOR COMMUNITY HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083084677
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRAYS HARBOR COMMUNITY HOSPITAL
Provider Business Mailing Address
First Line : 915 ANDERSON DR
Second Line :
City : ABERDEEN
State : WA
Zip : 98520-1006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 319 E PIONEER AVE
Second Line :
City : MONTESANO
State : WA
Zip : 98563-4601
Country : US
Telephone Number : 360-249-3300
Fax Number :
Authorized Official
Title or Position : CFO
Name : NIALL FOLEY
Credential :
Telephone Number : 360-537-5145
Provider Enumeration Date : 09/25/2015
Last Update Date : 10/14/2019

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Directions to “GRAYS HARBOR COMMUNITY HOSPITAL ” Practice Location

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