Provider Demographics
NPI:1932227105
Name:MOUNTAIN VIEW HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MOUNTAIN VIEW HOSPITAL DISTRICT
Other - Org Name:MOUNTAIN VIEW MEDICAL AND SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-460-4001
Mailing Address - Street 1:470 NE A ST
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-1844
Mailing Address - Country:US
Mailing Address - Phone:541-475-3882
Mailing Address - Fax:541-475-0610
Practice Address - Street 1:480 NE A ST
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1844
Practice Address - Country:US
Practice Address - Phone:541-460-4001
Practice Address - Fax:541-475-4804
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNTAIN VIEW HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-27
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR151024Medicaid
ORR115999Medicare PIN
OR151024Medicaid