# LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Odessa Memorial Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477666311
- **Authorized official:** JOHN SERLE (CEO)
- **Authorized official phone:** (509) 982-2611

## Contact information

- **Practice address:** 502 E. AMENDE, ODESSA, WA 99159
- **Practice address phone:** (509) 982-2611
- **Practice address fax:** (509) 982-2159
- **Mailing address:** PO BOX 368, ODESSA, WA 99159-0368
- **Mailing address phone:** (509) 982-2611
- **Mailing address fax:** (509) 982-2159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 04/20/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4208005 | — | WA |