Provider Demographics
NPI:1215040555
Name:CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO. 2
Entity Type:Organization
Organization Name:CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO. 2
Other - Org Name:LAKE CHELAN HOSPITAL SWING BED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-683-3300
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-0908
Mailing Address - Country:US
Mailing Address - Phone:509-682-3300
Mailing Address - Fax:509-682-9614
Practice Address - Street 1:110 S APPLE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8810
Practice Address - Country:US
Practice Address - Phone:509-682-3300
Practice Address - Fax:509-682-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-165275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA50Z334Medicare ID - Type Unspecified