Grant County Public Hospital District 2
Organization Active NPI Land Ambulance · Quincy, WA
NPI 1851465660 · NPPES record last updated Mar 4, 2008
Key facts
- NPI
- 1851465660
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 13X03 (WA)
- Legal business name
- GRANT COUNTY PUBLIC HOSPITAL DISTRICT 2
- Practice address
- 908 10TH Ave SW
Quincy, WA 98848-1376 - Phone
- (509) 787-3531
- Fax
- (509) 787-2016
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mehdi Merred
- Title
- Ceo
- Phone
- (509) 787-5346
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 5
Affiliated clinicians 26
-
Eva Ashford, PAC
-
Mark A. Broberg, M.D.
-
Sierra Butler, PA-C
-
Sean Caskey, D.O.
-
Joel D Cummings, MD
-
Amber D Dacy, ARNP
-
Fernando Dietsch Jr., M.D.
-
Gail R Feinman, MD
-
Kathy Fosnaugh, D.O.
-
Rebekah Marie Garfield, ARNP
-
Joel D. Hix, DPM
-
Anish A Kadakia, MD
-
Roy PO-Chou Lin, M.D.
-
Kathleen M Love, MD
-
Guenther Muens, M.D
-
Bethany Mulder, DO
-
Tyler A Sherman, D.O.
-
David Skale, M.D.
-
Lisa M Stone, MD
-
Leland Taylor, MD
-
Olivea Raine Taylor, PA-C
-
Julie Ann Thomas, APRN
-
Mark D Wefel, MD
Medicare Care Compare: Hospital
- Listed as
- Quincy Valley Medical Center
- Type
- Critical Access Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Hospital certification: CCN 501320
- Legal name
- GRANT COUNTY HOSPITAL DISTRICT NO. 2
- Doing business as
- QUINCY VALLEY MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Oct 1, 2002
- Last certification
- Aug 25, 2021
- Beds
- 29 (25 certified)
- Ownership / control type
- Hospital district or authority
- Organization structure
- Other · Non-profit
- Incorporated
- in WA
- Enrollment address
- 908 10TH Ave SW
Quincy, WA 98848-1376
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Glenda L Bishop |
Contracted Managing Employee |
Jul 1, 2017 | 100% |
| Corporate Officer |
Jul 1, 2017 | 100% | |
| Corporate Director |
Jul 1, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080903000156 | WA | Part a Provider - Critical Access Hospital | 8921919077 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Quincy, WA |
National Provider Directory
- Tax ID family
- Quincy Valley Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 13X03 | WA | Yes |
Addresses
Primary practice location
908 10TH Ave SW
Quincy, WA 98848-1376
Mailing address
908 10TH Ave SW
Quincy, WA 98848-1376
Phone (509) 787-3531
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9161407 | Medicaid | WA |
Other names
- Quincy Valley Medical Center
Other providers in Quincy, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.