Provider Demographics
NPI:1730956178
Name:MALHEUR COUNTY
Entity type:Organization
Organization Name:MALHEUR COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WISHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-889-7279
Mailing Address - Street 1:1108 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-4305
Mailing Address - Country:US
Mailing Address - Phone:541-889-7279
Mailing Address - Fax:541-889-8468
Practice Address - Street 1:1108 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-4305
Practice Address - Country:US
Practice Address - Phone:541-889-7279
Practice Address - Fax:541-889-8468
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MALHEUR COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local