TRI-STATE MEMORIAL HOSPITAL NPI 1760485221

NPI Information

NPI: 1760485221
Provider Name: TRI-STATE MEMORIAL HOSPITAL
Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

CLIA Number: 50D2209781

Address:
1221 HIGHLAND AVE
CLARKSTON, WA
ZIP 99403
Phone: (509) 758-5511
Get Directions

TRI-STATE MEMORIAL HOSPITAL is a critical access general acute care hospital in Clarkston, WA. TRI-STATE MEMORIAL HOSPITAL NPI is 1760485221. The provider is registered as an organization entity type.

The provider's business location address is:

1221 HIGHLAND AVE
CLARKSTON, WA
ZIP 99403-829
Phone: (509) 758-5511
Fax: (509) 751-9406

The provider's authorized official is Alex C Town .
The authorized official title is Cfo and has the following contact phone number (509) 758-4667.

The CLIA number assigned to this NPI record is 50D2209781 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2005 and was last updated on 3/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	H-108	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003110900	MEDICAID	IDAHO
2	1377710	MEDICARE PIN	IDAHO
3	00620	OTHER		BLUE CROSS OF IDAHO
4	501332	MEDICARE OSCAR/CERTIFICATION	WASHINGTON
5	000010002128	OTHER		REGENCE BLUE SHIELD OF IDAHO
6	003308004	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »