Provider Demographics
NPI:1215018197
Name:BAY AREA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BAY AREA HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-269-8130
Mailing Address - Street 1:3950 SHERMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-2872
Mailing Address - Country:US
Mailing Address - Phone:541-269-5454
Mailing Address - Fax:541-269-4665
Practice Address - Street 1:3950 SHERMAN AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-2872
Practice Address - Country:US
Practice Address - Phone:541-269-5454
Practice Address - Fax:541-269-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13141024251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH3814OtherMY ADVANTAGE MEDICARE HMO
OR3010OtherOHP MANAGED CARE
OR019679Medicaid
OR3010OtherOHP MANAGED CARE