Provider Demographics
NPI:1275067019
Name:PUBLIC HOSPITAL DISTRICT 1A OF WHITMAN COUNTY
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT 1A OF WHITMAN COUNTY
Other - Org Name:PULLMAN REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-334-4099
Mailing Address - Street 1:835 SE BISHOP BLVD
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5512
Mailing Address - Country:US
Mailing Address - Phone:509-332-2541
Mailing Address - Fax:509-332-0731
Practice Address - Street 1:835 SE BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5512
Practice Address - Country:US
Practice Address - Phone:509-332-2541
Practice Address - Fax:509-332-0731
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1366446767
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3303708OtherMOLINA - HOME HEALTH