MEDICARE: PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY

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

General Provider Information

NPI Number	:	1467881326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY

Provider Business Mailing Address
First Line	:	24261 NORTH US HIGHWAY 101
Second Line	:
City	:	HOODSPORT
State	:	WA
Zip	:	98548-0279
Country	:	US
Telephone Number	:	360-877-0372
Fax Number	:

Provider Business Practice Location Address
First Line	:	24261 NORTH US HIGHWAY 101
Second Line	:
City	:	HOODSPORT
State	:	WA
Zip	:	98548-0279
Country	:	US
Telephone Number	:	360-877-0372
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. ERIC MOLL
Credential	:
Telephone Number	:	360-427-9554

Provider Enumeration Date	:	11/01/2013
Last Update Date	:	09/13/2024

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