Provider Demographics
NPI:1588964407
Name:SOUTH GILLIAM COUNTY HEALTH DIST
Entity type:Organization
Organization Name:SOUTH GILLIAM COUNTY HEALTH DIST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIRMAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:KF
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-384-2061
Mailing Address - Street 1:422 NORTH MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:CONDON
Mailing Address - State:OR
Mailing Address - Zip Code:97823
Mailing Address - Country:US
Mailing Address - Phone:541-384-2061
Mailing Address - Fax:541-384-3121
Practice Address - Street 1:422 NORTH MAIN ST.
Practice Address - Street 2:
Practice Address - City:CONDON
Practice Address - State:OR
Practice Address - Zip Code:97823
Practice Address - Country:US
Practice Address - Phone:541-384-2061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care