Provider Demographics
NPI:1124480561
Name:EAST ADAMS RURAL HEALTH CARE
Entity type:Organization
Organization Name:EAST ADAMS RURAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:LL 00002836
Authorized Official - Phone:509-659-1600
Mailing Address - Street 1:1407 E THURSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-4242
Mailing Address - Country:US
Mailing Address - Phone:509-838-3341
Mailing Address - Fax:
Practice Address - Street 1:1407 E THURSTON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-4242
Practice Address - Country:US
Practice Address - Phone:509-838-3341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002836282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural