NPIMap

Organization Active NPI

Lincoln County Public Hospital District 1

Doing business as Odessa Memorial Healthcare Center

  • Ambulance
  • Odessa, WA
National Provider Identifier
1245343193
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
H-080 Issued in WA
Legal business name
LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1
Doing business as
Odessa Memorial Healthcare Center
Practice address
502 E Amende
Odessa, WA 99159
Phone
(509) 982-2611
Fax
(509) 982-2159
NPI assigned
Aug 16, 2006
Last updated
Jun 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Audra Ann Merkle
Title
Executive Assistant
Phone
(509) 982-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X H-080 WA Primary

Addresses

Primary practice location

502 E Amende
Odessa, WA 99159

Mailing address

PO Box 368
Odessa, WA 99159-0368
Phone (509) 982-2611

Other identifiers 2

IdentifierTypeStateIssuer
9038936MedicaidWA
129183OtherWADEPT LABOR & INDUSTRIES

Other names 1

  • Odessa Memorial Healthcare Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041215000890 WA Part A Provider - Critical Access Hospital 1052209152 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Odessa, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245343193. Details of each certification follow.

Hospital certification: CCN 501307

Legal name
LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1
Doing business as
ODESSA MEMORIAL HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2001
Last certification
Apr 21, 2022
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Nov 5, 1946 in WA
Enrollment address
502 E Amende Dr
Odessa, WA 99159-7003
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Odessa Memorial Healthcare CenterCCN 501307 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lincoln County Public Hospital District 1 Organization, Odessa, WA 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Brett Antczak Individual Corporate OfficerChief Executive Officer Jan 26, 2023
Audra Merkle Individual Operational/Managerial ControlExecutive Assistant Sep 1, 2023
Brian Fink Individual Corporate DirectorBoard Chairman Jan 1, 2019

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 10

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1245343193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "ODESSA",
            "state": "WA",
            "postal_code": "991590368",
            "telephone_number": "509-982-2611",
            "fax_number": "509-982-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E AMENDE",
            "city": "ODESSA",
            "state": "WA",
            "postal_code": "99159",
            "telephone_number": "509-982-2611",
            "fax_number": "509-982-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "MERKLE",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "509-982-2611"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WA",
            "license": "H-080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9038936",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT LABOR & INDUSTRIES",
            "identifier": "129183",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odessa Memorial Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Odessa Memorial Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, WA

Sources for this page

Verify at the official NPI Registry.