Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 579 E Main St, Elma, Washington |
Authorized Official Name and Position | Lynn Fifield (MEDICAL STAFF SERVICES DIRECTOR) |
Authorized Official Contact | 3603462222 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Grays Harbor Public Hospital District No 1 600 E Main Street Elma WA 98541 Ph: (360) 346-2222 | 579 E Main St Bldg 2 Elma WA 98541 Ph: (360) 346-2222 |
NPI Number | 1083202907 |
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Provider Enumeration Date | 01/06/2021 |
Last Update Date | 05/23/2023 |
Medicare PECOS PAC ID | 9032017256 |
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Medicare Enrollment ID | O20210316001628 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083202907 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Pacific Medical Specialty Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1117 W Young St, Elma, WA 98541 Phone: 503-805-8865 | |
Olympic Valley Clinic, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11 Schouweiler Rd, Elma, WA 98541 Phone: 360-482-5300 Fax: 360-482-5900 | |