Provider Demographics
NPI:1386699858
Name:DOUGLAS COUNTY HOSPITAL DIST #2
Entity type:Organization
Organization Name:DOUGLAS COUNTY HOSPITAL DIST #2
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELONNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REJNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-745-8448
Mailing Address - Street 1:117 SO CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98858-0400
Mailing Address - Country:US
Mailing Address - Phone:509-745-8448
Mailing Address - Fax:509-745-8448
Practice Address - Street 1:117 S CHELAN
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:WA
Practice Address - Zip Code:98858-0400
Practice Address - Country:US
Practice Address - Phone:509-745-8448
Practice Address - Fax:509-745-8448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA503803Medicare Oscar/Certification