Provider Demographics
NPI:1639254204
Name:SILVERTON HOSPITAL
Entity Type:Organization
Organization Name:SILVERTON HOSPITAL
Other - Org Name:MOLALLA SPECIALIST CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:FRITSCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-873-1548
Mailing Address - Street 1:452 WELCH ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1934
Mailing Address - Country:US
Mailing Address - Phone:503-873-1722
Mailing Address - Fax:503-874-2479
Practice Address - Street 1:861 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOLALLA
Practice Address - State:OR
Practice Address - Zip Code:97038
Practice Address - Country:US
Practice Address - Phone:503-873-1722
Practice Address - Fax:503-874-2479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR=========OtherTAX ID