Organization
LAKE HEALTH DISTRICT
Active
Other names
Lake District Hospital and LTC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BODELL TVEIT (CEO)
(541) 947-7307
Entity
Organization
Contact information
Practice address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
(541) 947-2433
Mailing address
700 S J ST, LAKEVIEW, OR 97630-1623
(541) 947-2114
(541) 947-2433
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
140896
OR
333600000X
Pharmacy
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106146
—
OR
01
—
107532
MEDICAID OREGON HEALTH
OR
01
—
802595
MEDICAID OREHEALTH L.T.C.
OR
Enumeration date
01/24/2007
Last updated
01/21/2021
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