| Lewis County Hospital District No. 1 | |
|
108 Kindle Road Randle WA 98377 | |
| (360) 497-3333 | |
| (360) 497-5073 |
| Full Name | Lewis County Hospital District No. 1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 108 Kindle Road, Randle, Washington |
| Authorized Official Name and Position | Richard Boggess (CFO) |
| Authorized Official Contact | 3604965112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis County Hospital District No. 1 Po Box 1138 Morton WA 98356-0019 Ph: (360) 496-5112 | Lewis County Hospital District No. 1 108 Kindle Road Randle WA 98377 Ph: (360) 497-3333 |
| NPI Number | 1689604563 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 08/20/2019 |
| Medicare PECOS PAC ID | 6002727385 |
|---|---|
| Medicare Enrollment ID | O20030911000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689604563 | NPI | - | NPPES |
| 7111230 | Medicaid | WA | |
| DB0062 | Other | WA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H173 (Washington) | Primary |
Lewis County Hospital District No. 1 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Kindle Road, Randle, WA 98377 Phone: 360-497-3333 Fax: 360-497-5073 |