MEDICARE: GARFIELD COUNTY MEMORIAL HOSPITAL DISTRICT

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
1	261QR1300X	Rural Health Clinic/Center	503982	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7105463	OTHER	WA	MEDICA RURAL HEALTH ENCO

General Provider Information

NPI Number	:	1114028693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARFIELD COUNTY MEMORIAL HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	66 N 6TH ST
Second Line	:
City	:	POMEROY
State	:	WA
Zip	:	99347-9705
Country	:	US
Telephone Number	:	509-843-1491
Fax Number	:	509-843-1740

Provider Business Practice Location Address
First Line	:	446 PATAHA ST
Second Line	:
City	:	POMEROY
State	:	WA
Zip	:	99347-8634
Country	:	US
Telephone Number	:	509-843-1491
Fax Number	:	509-843-1740

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	HOLLIE WINSLOW
Credential	:
Telephone Number	:	509-566-4147

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	10/25/2024

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Directions to “GARFIELD COUNTY MEMORIAL HOSPITAL DISTRICT ” Practice Location

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