Provider Demographics
NPI:1376844522
Name:SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 304
Entity Type:Organization
Organization Name:SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 304
Other - Org Name:UNITED GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-856-6021
Mailing Address - Street 1:2000 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-4327
Mailing Address - Country:US
Mailing Address - Phone:360-856-7466
Mailing Address - Fax:360-856-7300
Practice Address - Street 1:2000 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-4327
Practice Address - Country:US
Practice Address - Phone:360-856-7466
Practice Address - Fax:360-856-7300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 304
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-04
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH2063336C0002X, 3336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6019624Medicaid