| Lincoln County Public Hospital District 1 | |
|
510 E Amende Odessa WA 99159 | |
| (509) 982-2611 | |
| (509) 982-2159 |
| Full Name | Lincoln County Public Hospital District 1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 E Amende, Odessa, Washington |
| Authorized Official Name and Position | John Serle (CEO) |
| Authorized Official Contact | 5099822611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln County Public Hospital District 1 Po Box 190 Odessa WA 99159-0190 Ph: (509) 982-2611 | Lincoln County Public Hospital District 1 510 E Amende Odessa WA 99159 Ph: (509) 982-2611 |
| NPI Number | 1023122520 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 04/20/2021 |
| Medicare PECOS PAC ID | 1052209152 |
|---|---|
| Medicare Enrollment ID | O20041221000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023122520 | NPI | - | NPPES |
| 7105539 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Lincoln County Public Hospital District 1 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 E. Amende, Odessa, WA 99159 Phone: 509-982-2611 Fax: 509-982-2675 |