Organization
LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1
Active
Other names
Odessa Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SERLE (CEO)
(509) 982-2611
Entity
Organization
Contact information
Practice address
510 E AMENDE, ODESSA, WA 99159
(509) 982-2611
(509) 982-2159
Mailing address
PO BOX 190, ODESSA, WA 99159-0190
(509) 982-2611
(509) 982-2159
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7105539
—
WA
Enumeration date
08/19/2006
Last updated
04/20/2021
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