Provider Demographics
NPI:1487685004
Name:MORROW COUNTY HEALTH DISTRICT
Entity Type:Organization
Organization Name:MORROW COUNTY HEALTH DISTRICT
Other - Org Name:PIONEER MEMORIAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-676-5504
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-0009
Mailing Address - Country:US
Mailing Address - Phone:541-676-5504
Mailing Address - Fax:541-676-9025
Practice Address - Street 1:130 THOMPSON AVE.
Practice Address - Street 2:
Practice Address - City:HEPPNER
Practice Address - State:OR
Practice Address - Zip Code:97836
Practice Address - Country:US
Practice Address - Phone:541-676-5504
Practice Address - Fax:541-676-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR141444261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR168725Medicaid
OR168725Medicaid