CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO 2

Provider Demographics

• NPI: 1578568853
• Name: CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO 2
• Entity Type: Organization
• Organization Name: CHELAN COUNTY PUBLIC HOSPITAL DISTRICT NO 2
• Other - Org Name: LAKE CHELAN COMMUNITY HOSPITAL
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: AARON
• Authorized Official - Middle Name: CHRISTOPHER
• Authorized Official - Last Name: EDWARDS
• Authorized Official - Phone: 509-683-3300
• Mailing Address - Street 1: PO BOX 908
• Mailing Address - City: CHELAN
• Mailing Address - State: WA
• Mailing Address - Zip Code: 98816-0908
• Mailing Address - Country: US
• Mailing Address - Phone: 509-682-3300
• Mailing Address - Fax: 509-682-6131
• Practice Address - Street 1: 110 S APPLE BLOSSOM DR
• Practice Address - City: CHELAN
• Practice Address - State: WA
• Practice Address - Zip Code: 98816-8810
• Practice Address - Country: US
• Practice Address - Phone: 509-682-3300
• Practice Address - Fax: 509-682-9614
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-06-14
• Last Update Date: 2023-04-25

Provider Licenses

State	License ID	Taxonomies
WA	H-165	282N00000X, 282NC0060X, 282NR1301X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	282NC0060X	Hospitals	General Acute Care Hospital	Critical Access
No	282N00000X	Hospitals	General Acute Care Hospital
No	282NR1301X	Hospitals	General Acute Care Hospital	Rural

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WA	=========	Other	TAX ID NUMBER
WA	S30631	Medicare UPIN
WA	P80777	Medicare UPIN
WA	A07564	Medicare UPIN
WA	PY2376	Medicare UPIN
WA	R64210	Medicare UPIN
WA	E67155	Medicare UPIN
WA	R70897	Medicare UPIN
WA	R86298	Medicare UPIN
WA	=========	Other	TAX ID NUMBER
WA	R88174	Medicare UPIN
WA	S21609	Medicare UPIN
WA	A07044	Medicare UPIN
WA	S56739	Medicare UPIN
WA	501334	Medicare ID - Type Unspecified	PROVIDER NUMBER
WA	H52121	Medicare UPIN