Provider Demographics
NPI:1104849058
Name:ADAMS COUNTY HOSPITAL 2
Entity type:Organization
Organization Name:ADAMS COUNTY HOSPITAL 2
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-659-1200
Mailing Address - Street 1:903 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:RITZVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99169-2227
Mailing Address - Country:US
Mailing Address - Phone:509-646-3290
Mailing Address - Fax:
Practice Address - Street 1:545 SE CHURCH STREET
Practice Address - Street 2:
Practice Address - City:WASHTUCNA
Practice Address - State:WA
Practice Address - Zip Code:99371
Practice Address - Country:US
Practice Address - Phone:509-646-3290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
508542OtherMEDICARE
WA8157364Medicaid
WA0050906OtherWA L&I
WA0051688OtherWA L&I
WA0203688OtherWA L&I
WA0148592OtherWA L&I
WA0156841OtherWA L&I
WA8119547Medicaid
WAQ61323Medicare UPIN
WAF28137Medicare UPIN
WA0203688OtherWA L&I
WAG8858038Medicare ID - Type Unspecified
WAG8803973Medicare ID - Type Unspecified
WA8157364Medicaid
WA508542Medicare Oscar/Certification
WA8119547Medicaid
WAE72454Medicare UPIN
WAG8803965Medicare ID - Type Unspecified