Provider Demographics
NPI:1689812620
Name:COUNTY OF HARNEY
Entity Type:Organization
Organization Name:COUNTY OF HARNEY
Other - Org Name:HARNEY COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY JUDGE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-573-6356
Mailing Address - Street 1:420 N. FAIRVIEW
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720
Mailing Address - Country:US
Mailing Address - Phone:541-573-2271
Mailing Address - Fax:541-573-8388
Practice Address - Street 1:420 N FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720-1416
Practice Address - Country:US
Practice Address - Phone:541-573-2271
Practice Address - Fax:541-573-8388
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF HARNEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-29
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X
ORMD171944251K00000X
OR201707154NP-PP364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR042932Medicaid