Provider Demographics
NPI:1689720435
Name:CASCADE MEDICAL CENTER HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CASCADE MEDICAL CENTER HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HASBROUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-408-5025
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:ID
Mailing Address - Zip Code:83611-1330
Mailing Address - Country:US
Mailing Address - Phone:208-382-4242
Mailing Address - Fax:208-382-3580
Practice Address - Street 1:402 LAKE CASCADE PKWY
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:ID
Practice Address - Zip Code:83611-7702
Practice Address - Country:US
Practice Address - Phone:208-382-4242
Practice Address - Fax:208-382-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID34282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002428400Medicaid
ID1251407OtherCIGNA PART B
ID002428400Medicaid
ID13Z308Medicare Oscar/Certification