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Contact Information

TRI-STATE MEMORIAL HOSPITAL
1100 HIGHLAND AVENUE
CLARKSTON, WA99403
 Phone: 509-758-2568
 Fax: 509-758-3413
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
Indicates primary specialty

NPI Profile & details for TRI-STATE MEMORIAL HOSPITAL

NPI Number 1124135215
LBN Legal business name TRI-STATE MEMORIAL HOSPITAL
Authorized official ALEX TOWN - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/24/2006
Last updated 05/16/2012 - About 14 years ago
Identifiers
WA License # 15457
WA Medicaid 9044330
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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