Provider Demographics
NPI:1659387041
Name:ADAMS COUNTY HOSPITAL 2
Entity Type:Organization
Organization Name:ADAMS COUNTY HOSPITAL 2
Other - Org Name:RITZVILLE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTALING
Authorized Official - Prefix:
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-659-1200
Mailing Address - Street 1:903 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:RITZVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99169-2227
Mailing Address - Country:US
Mailing Address - Phone:509-659-5402
Mailing Address - Fax:509-659-1252
Practice Address - Street 1:903 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:RITZVILLE
Practice Address - State:WA
Practice Address - Zip Code:99169-2227
Practice Address - Country:US
Practice Address - Phone:509-659-5402
Practice Address - Fax:509-659-1252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8157364Medicaid
WA7105489Medicaid
WA7144503Medicaid
WA0050906OtherWA L&I
WA0148592OtherWA L&I
WA0156841OtherWA L&I
WA8119547Medicaid
WA0203688OtherWA L&I
WA0051688OtherWA L&I
WAQ17190Medicare UPIN
WAF28137Medicare UPIN
WAG000356504Medicare ID - Type Unspecified
WA8157364Medicaid
WA7144503Medicaid
WAQ61323Medicare UPIN
WA8119547Medicaid
WA7105489Medicaid
WA503983Medicare Oscar/Certification
WAE72454Medicare UPIN
WA0050906OtherWA L&I