Provider Demographics
NPI:1033473517
Name:OUR LADY OF LOURDES HOSPITAL AT PASCO
Entity Type:Organization
Organization Name:OUR LADY OF LOURDES HOSPITAL AT PASCO
Other - Org Name:LOURDES HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-543-2483
Mailing Address - Street 1:4215 CONVENTION PL
Mailing Address - Street 2:SUITE B
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8148
Mailing Address - Country:US
Mailing Address - Phone:509-416-8849
Mailing Address - Fax:
Practice Address - Street 1:4215 CONVENTION PL
Practice Address - Street 2:SUITE B
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8148
Practice Address - Country:US
Practice Address - Phone:509-416-8849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty