| Legacy Mount Hood Medical Center | |
|
24800 Se Stark St Gresham OR 97030-3378 | |
| (503) 674-1122 | |
| Not Available |
| Full Name | Legacy Mount Hood Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 24800 Se Stark St, Gresham, Oregon |
| Authorized Official Name and Position | Sarah Jensen (INTERIM CFO) |
| Authorized Official Contact | 5034155145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Mount Hood Medical Center Po Box 4037 Portland OR 97208-4037 Ph: (503) 413-3958 | Legacy Mount Hood Medical Center 24800 Se Stark St Gresham OR 97030-3378 Ph: (503) 674-1122 |
| NPI Number | 1255354700 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 11/20/2017 |
| Medicare PECOS PAC ID | 3173515996 |
|---|---|
| Medicare Enrollment ID | O20050706001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255354700 | NPI | - | NPPES |
| 138002500 | Other | OR | REGENCE BLUE CROSS |
| XHSP30551 | Medicaid | CA | |
| 069526 | Medicaid | OR | |
| 0033644 | Medicaid | ID | |
| XHSP40551 | Medicaid | CA | |
| HSJIPOR | Medicaid | AK |
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