Provider Demographics
NPI:1114476496
Name:OUR LADY OF LOURDES HOSPTIAL AT PASCO
Entity Type:Organization
Organization Name:OUR LADY OF LOURDES HOSPTIAL AT PASCO
Other - Org Name:LOURDES HEALTH CRISIS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/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:509-416-8849
Mailing Address - Street 1:520 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5257
Mailing Address - Country:US
Mailing Address - Phone:509-416-8849
Mailing Address - Fax:509-542-3059
Practice Address - Street 1:500 N MORAIN ST
Practice Address - Street 2:SUITE 1250
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2950
Practice Address - Country:US
Practice Address - Phone:509-783-0500
Practice Address - Fax:509-783-9129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health