NPIMap

Organization Active NPI

Wallowa County Health Care District

Doing business as Wallowa Memorial Hospital-Hospice

  • Community Based Hospice Care Agency
  • Enterprise, OR
National Provider Identifier
1922004738
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
14 0068 Issued in OR
Legal business name
WALLOWA COUNTY HEALTH CARE DISTRICT
Doing business as
Wallowa Memorial Hospital-Hospice
Practice address
403 NE 1St St
Enterprise, OR 97828-1167
Phone
(541) 426-3111
Fax
(541) 426-4095
NPI assigned
Jun 27, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Larry S Davy, RN
Title
Ceo/Administrator
Phone
(541) 426-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 14 0068 OR Primary

Addresses

Primary practice location

403 NE 1St St
Enterprise, OR 97828-1167

Mailing address

401 NE 1St St
Enterprise, OR 97828-1167
Phone (541) 426-3111

Other identifiers 1

IdentifierTypeStateIssuer
237040MedicaidOR

Other names 1

  • Wallowa Memorial Hospital-Hospice Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

401 NE 1st St
Enterprise, OR 97828
Phone (541) 426-3111

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922004738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NE 1ST ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281167",
            "telephone_number": "541-426-3111",
            "fax_number": "541-426-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 NE 1ST ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281167",
            "telephone_number": "541-426-3111",
            "fax_number": "541-426-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLOWA COUNTY HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "541-426-5300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OR",
            "license": "14   0068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237040",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wallowa Memorial Hospital-Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.