Provider Demographics
NPI:1093819211
Name:LINCOLN COUNTY HOSPITAL DISTRICT #3
Entity Type:Organization
Organization Name:LINCOLN COUNTY HOSPITAL DISTRICT #3
Other - Org Name:LINCOLN HOSPITAL SKILLED NURSING FACILITY
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARCI
Authorized Official - Middle Name:D
Authorized Official - Last Name:LINSTRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-725-7101
Mailing Address - Street 1:10 NICHOLS ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99122-9729
Mailing Address - Country:US
Mailing Address - Phone:509-725-7101
Mailing Address - Fax:509-725-2112
Practice Address - Street 1:10 NICHOLS ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:WA
Practice Address - Zip Code:99122-9729
Practice Address - Country:US
Practice Address - Phone:509-725-7101
Practice Address - Fax:509-725-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-137314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACJ6525OtherMEDICARE RAILROAD
WA4213708Medicaid
WA7117450Medicaid
WA7101132Medicaid
WA50-5443Medicare Oscar/Certification
WA508529Medicare Oscar/Certification
WA4213708Medicaid