Provider Demographics
NPI:1366609489
Name:PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Entity type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:G
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:APPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-427-9573
Mailing Address - Street 1:PO BOX 1668
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-5001
Mailing Address - Country:US
Mailing Address - Phone:360-427-9573
Mailing Address - Fax:360-427-9597
Practice Address - Street 1:901 MT VIEW DR BLDG 1
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-4401
Practice Address - Country:US
Practice Address - Phone:360-427-9573
Practice Address - Fax:360-427-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2320029693282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA500118Medicare Oscar/Certification