Provider Demographics
NPI:1619460227
Name:CURRY HEALTH DISTRICT
Entity Type:Organization
Organization Name:CURRY HEALTH DISTRICT
Other - Org Name:CURRY MEDICAL WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SHELLIE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:WILLCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-412-2073
Mailing Address - Street 1:94220 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GOLD BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97444-7756
Mailing Address - Country:US
Mailing Address - Phone:541-247-3000
Mailing Address - Fax:541-247-3159
Practice Address - Street 1:94125 FOURTH STREET
Practice Address - Street 2:
Practice Address - City:GOLD BEACH
Practice Address - State:OR
Practice Address - Zip Code:97444
Practice Address - Country:US
Practice Address - Phone:541-247-6628
Practice Address - Fax:541-247-6629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CURRY HEALTH DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14-0251261QC0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORPENDINGMedicaid