Provider Demographics
NPI:1467881326
Name:PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Other - Org Name:MASON HEALTH-MASON CLINIC HOODSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-427-9554
Mailing Address - Street 1:24261 NORTH US HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:HOODSPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98548-0279
Mailing Address - Country:US
Mailing Address - Phone:360-877-0372
Mailing Address - Fax:
Practice Address - Street 1:24261 NORTH US HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:HOODSPORT
Practice Address - State:WA
Practice Address - Zip Code:98548-0279
Practice Address - Country:US
Practice Address - Phone:360-877-0372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA508566Medicare Oscar/Certification