Provider Demographics
NPI:1073782470
Name:HARNEY DISTRICT HOSPITAL
Entity Type:Organization
Organization Name:HARNEY DISTRICT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-573-7281
Mailing Address - Street 1:557 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720-1441
Mailing Address - Country:US
Mailing Address - Phone:541-573-7281
Mailing Address - Fax:541-573-8627
Practice Address - Street 1:557 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720-1441
Practice Address - Country:US
Practice Address - Phone:541-573-7281
Practice Address - Fax:541-573-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1304341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9053638Medicaid
AZ934069Medicaid
WA0213747OtherWASHINGTON DEPT LABOR
OR226328Medicaid
AKGA5570RMedicaid