Provider Demographics
NPI:1811108822
Name:ADAMS COUNTY PUBLIC HOSPITAL DISTRICT 3
Entity type:Organization
Organization Name:ADAMS COUNTY PUBLIC HOSPITAL DISTRICT 3
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-331-2664
Mailing Address - Street 1:315 N 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344-1254
Mailing Address - Country:US
Mailing Address - Phone:509-488-2636
Mailing Address - Fax:509-331-2617
Practice Address - Street 1:315 N 14TH AVE
Practice Address - Street 2:
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344-1254
Practice Address - Country:US
Practice Address - Phone:509-331-2664
Practice Address - Fax:509-331-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA282NC0060X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3322302Medicaid
25710OtherL&I
50Z318Medicare Oscar/Certification
501318Medicare Oscar/Certification