Provider Demographics
NPI:1619189909
Name:KENNEWICK PUBLIC HEALTH DISTRICT
Entity Type:Organization
Organization Name:KENNEWICK PUBLIC HEALTH DISTRICT
Other - Org Name:KENNEWICK GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-585-5349
Mailing Address - Street 1:PO BOX 6128
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-0128
Mailing Address - Country:US
Mailing Address - Phone:509-586-6111
Mailing Address - Fax:
Practice Address - Street 1:900 S AUBURN ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5621
Practice Address - Country:US
Practice Address - Phone:509-586-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0193210OtherL&I RAD READING FEES
WA7002017Medicaid
WACZ0082OtherMEDICARE RAILROAD