Provider Demographics
NPI:1982692372
Name:SHERMAN COUNTY HEALTH DISTRICT
Entity Type:Organization
Organization Name:SHERMAN COUNTY HEALTH DISTRICT
Other - Org Name:SHERMAN COUNTY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-565-0536
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:MORO
Mailing Address - State:OR
Mailing Address - Zip Code:97039-0186
Mailing Address - Country:US
Mailing Address - Phone:541-565-0536
Mailing Address - Fax:541-565-3617
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:MORO
Practice Address - State:OR
Practice Address - Zip Code:97039-3080
Practice Address - Country:US
Practice Address - Phone:541-565-0536
Practice Address - Fax:541-565-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR165028Medicaid
OR383820OtherMEDICARE-PTAN