Provider Demographics
NPI:1073763314
Name:GRAYS HARBOR COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:GRAYS HARBOR COMMUNITY HOSPITAL
Other - Org Name:GHCH REHAB THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-537-6116
Mailing Address - Street 1:1006 N H ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-2521
Mailing Address - Country:US
Mailing Address - Phone:360-537-6116
Mailing Address - Fax:360-537-6100
Practice Address - Street 1:575 E MAIN ST
Practice Address - Street 2:BUILDING 1 SUIET A
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541-9551
Practice Address - Country:US
Practice Address - Phone:360-537-6116
Practice Address - Fax:360-537-6100
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAYS HARBOR COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-23
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000860100Medicare PIN