Provider Demographics
NPI:1184170748
Name:WALLOWA COUNTY HEALTH CARE DISTRICT
Entity type:Organization
Organization Name:WALLOWA COUNTY HEALTH CARE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WANNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-426-5460
Mailing Address - Street 1:16351 E 104TH PL
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-8843
Mailing Address - Country:US
Mailing Address - Phone:609-605-9200
Mailing Address - Fax:
Practice Address - Street 1:16351 E. 104TH PLACE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022
Practice Address - Country:US
Practice Address - Phone:609-605-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health