TRI-STATE MEMORIAL HOSPITAL (NPI# 1124135215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124135215 |
| Entity Type | Organization |
| Organization Name | TRI-STATE MEMORIAL HOSPITAL |
| Practice Address |
1100 Highland Avenue Clarkston WA 99403 |
| Mailing Address |
Po Box 187 Clarkston WA 99403-0187 |
| Practice Telephone | 5097582568 |
| Practice Fax Number | 5097583413 |
| Mailing Telephone | 5097585511 |
| Mailing Fax Number | 5097519406 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2012-05-16 |
| Authorized Official Name | MR. ALEX C TOWN (CFO) |
| Authorized Official Telephone | 5097584667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 15457 | WA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 9044330 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174697353 | Tri-state Memorial Hospital | Medicare Defined Swing Bed Unit | 1221 Highland Avenue, Clarkston, WA 99403 | 2006-11-20 |
| 1831100254 | Tri-state Memorial Hospital | Hospice Care, Community Based | 1100 Highland Avenue, Clarkston, WA 99403 | 2006-08-10 |
| 1386690907 | Tri-state Memorial Hospital | Clinic/Center | 730 21st St, Lewiston, ID 83501-3323 | 2006-05-25 |
| 1760485221 | Tri-state Memorial Hospital | General Acute Care Hospital | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2005-05-27 |
| 1932405693 | Tri-state Memorial Hospital | Internal Medicine | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2011-01-28 |
| 1598814352 | Tri-state Memorial Hospital | Family Medicine | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2007-01-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | TRI-STATE MEMORIAL HOSPITAL | 1221 Highland Ave, Clarkston, WA 99403-2829 |
| Street Address |
1100 HIGHLAND AVENUE |
| City | CLARKSTON |
| State | WA |
| Zip Code | 99403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831100254 | Tri-state Memorial Hospital | Hospice Care, Community Based | 1100 Highland Avenue, Clarkston, WA 99403 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409669 | Jessica Elaine Krull | Specialist/Technologist | 807 3rd Street, Clarkston, WA 99403 | 2019-04-22 |
| 1477006526 | Idaho County Rideshare | Non-emergency Medical Transport (VAN) | 1470 Elm Street, Clarkston, WA 99403 | 2016-07-25 |
| 1679921340 | Jonathan Preszler | Counselor | 629 6th Street, Educational and Psychological Services, Clarkston, WA 99403 | 2016-06-02 |
| 1104204957 | Optimal Health and Wellness | Clinic/Center | 1267 Belmont Way, Clarkston, WA 99403 | 2015-05-13 |
| 1326456351 | David Nygren | Pharmacist | 506 5th St, Clarkston, WA 99403 | 2014-07-22 |
| 1255672895 | Alpowa Healthcare, Inc. | Hospice Care, Community Based | 1370 Bridge Street, Clarkston, WA 99403 | 2013-03-06 |
| 1265799407 | Elizabeth Bagnulo Dacey | Pathology | 1225 Highland Avenue, Clarkston, WA 99403 | 2012-04-12 |
| 1649586256 | Zeeshan Afzal | Internal Medicine | 1119 Highland Ave Ste 3, Clarkston, WA 99403 | 2010-08-20 |
| 1154657955 | Twin River Vision, Inc. | Optometrist | 306 5th Street, Clarkston, WA 99403 | 2009-10-29 |
| 1649429317 | Elizabeth Marie Allen-racicot | Specialist | 1013 Bridge Street, Clarkston, WA 99403 | 2008-09-17 |
| Find all providers in zip 99403 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726401 | Maitland Healthcare Services LLC | Home Health | 6060 Dixie Hwy Ste A, Clarkston, MI 48346-3476 | 2020-09-29 |
| 1790134393 | Anna's Angels | Home Health | 3702 Pinoak St, Clarkston, MI 48348-1379 | 2016-06-06 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1164837274 | Akosua Lynique Yeboah | Home Health | 1048 Noble Vines Dr Apt 4, Clarkston, GA 30021-1326 | 2014-06-26 |
| 1205066115 | Quality One Home Healthcare, LLC | Home Health | 3942 Memorial College Ave, Apt 7, Clarkston, GA 30021-2451 | 2009-07-27 |
| 1487804209 | Tender Loving Care Health Care Services of Michigan, L.L.C. | Home Health | 7457 M E Cad Blvd, Suite 200, Clarkston, MI 48348-4282 | 2008-09-29 |
| 1760631329 | Ideal Home Health Services LLC | Home Health | 6751 Dixie Hwy Ste 202, Clarkston, MI 48346-2080 | 2008-09-18 |
| 1366611642 | Linco Healthcare System LLC | Home Health | 2802 The Oaks, Clarkston, GA 30021-1233 | 2008-02-21 |
| 1639241219 | Evergreen Health Services, Inc. | Home Health | 6510 Town Center Dr, Suite# B, Clarkston, MI 48346-4822 | 2006-11-15 |
| 1598867897 | Unicare Home Health, Inc | Home Health | 6060 Dixie Hwy, Suite G, Clarkston, MI 48346-3476 | 2006-09-05 |
| Find all providers in CLARKSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.