Organization
WALLOWA COUNTY HEALTH CARE DISTRICT
Active
Other names
Wallowa Memorial Hospital-Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY S DAVY RN (CEO/ADMINISTRATOR)
(541) 426-5300
Entity
Organization
Contact information
Practice address
403 NE 1ST ST, ENTERPRISE, OR 97828-1167
(541) 426-3111
(541) 426-4095
Mailing address
401 NE 1ST ST, ENTERPRISE, OR 97828-1167
(541) 426-3111
(541) 426-4095
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
14 0068
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237040
—
OR
Enumeration date
06/27/2005
Last updated
08/22/2020
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