Provider Demographics
NPI:1528195054
Name:LOWER UMPQUA HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LOWER UMPQUA HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHNATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-271-6313
Mailing Address - Street 1:600 RANCH RD
Mailing Address - Street 2:
Mailing Address - City:REEDSPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97467-1720
Mailing Address - Country:US
Mailing Address - Phone:541-271-2171
Mailing Address - Fax:541-271-6380
Practice Address - Street 1:600 RANCH RD
Practice Address - Street 2:
Practice Address - City:REEDSPORT
Practice Address - State:OR
Practice Address - Zip Code:97467-1720
Practice Address - Country:US
Practice Address - Phone:541-271-2171
Practice Address - Fax:541-271-2941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR106716Medicaid