NPIMap

Organization Active NPI

Klickitat County Public Hospital Dist No 1

  • Clinic/Center
  • Goldendale, WA
National Provider Identifier
1669634747
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
202000768 Issued in WA
Legal business name
KLICKITAT COUNTY PUBLIC HOSPITAL DIST NO 1
Practice address
310 S Roosevelt Ave
Goldendale, WA 98620-9201
Phone
(509) 773-4022
Fax
(509) 773-1941
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
John Rohrer
Title
Ceo
Phone
(509) 773-4022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 202000768 WA Primary

Addresses

Primary practice location

310 S Roosevelt Ave
Goldendale, WA 98620-9201

Mailing address

310 S Roosevelt Ave
Goldendale, WA 98620-9201
Phone (509) 773-4022

Other identifiers 1

IdentifierTypeStateIssuer
7591134MedicaidWA

Other names 1

  • KLICKITAT VALLEY HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Pracitice Clinic7 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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1669634747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S ROOSEVELT AVE",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "986209201",
            "telephone_number": "509-773-4022",
            "fax_number": "509-773-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S ROOSEVELT AVE",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "986209201",
            "telephone_number": "509-773-4022",
            "fax_number": "509-773-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLICKITAT COUNTY PUBLIC HOSPITAL DIST NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "ROHRER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-773-4022"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "202000768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7591134",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KLICKITAT VALLEY HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goldendale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.