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NPI Code Detail

MEDICARE: WALLA WALLA GENERAL HOSPITAL

MEDICARE: WALLA WALLA GENERAL 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
1261QM1300XMulti-Specialty Clinic/Center
2282N00000XGeneral Acute Care HospitalHAC.FS.00000043WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760466114
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALLA WALLA GENERAL HOSPITAL
Provider Business Mailing Address
First Line : PO BOX 1398
Second Line :
City : WALLA WALLA
State : WA
Zip : 99362-0309
Country : US
Telephone Number : 509-525-0480
Fax Number : 509-527-8159
Provider Business Practice Location Address
First Line : 1025 S 2ND AVE
Second Line :
City : WALLA WALLA
State : WA
Zip : 99362-4116
Country : US
Telephone Number : 509-525-0480
Fax Number : 509-527-8159
Authorized Official
Title or Position : CEO
Name : MR. RICK D BOCKMANN
Credential :
Telephone Number : 509-525-0480
Provider Enumeration Date : 11/30/2005
Last Update Date : 03/30/2017

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
1063413334 — MR. BARRY MICHAEL MALLARD RPH
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1710989181 — DR. LISA J THOROUGHMAN PHARMD
Practice Location Address:
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WALLA WALLA, WA
99362-4116
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Practice Fax: 509-527-8183
1962495994 — DR. CHRISTOPHER K JENKINS DO
Practice Location Address:
1025 S 2ND AVE
WALLA WALLA, WA
99362-4116
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Practice Fax:
1508840521 — DR. DOUGLAS E NEWTON MD
Practice Location Address:
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WALLA WALLA, WA
99362-4116
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1467436030 — WALLA WALLA GENERAL HOSPITAL
Practice Location Address:
1025 S 2ND AVE
WALLA WALLA, WA
99362-4116
Practice Phone: 509-525-0480
Practice Fax: 509-527-8195

Directions to “WALLA WALLA GENERAL HOSPITAL ” Practice Location

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