Provider Demographics
NPI:1861941254
Name:RUNDU INTERMEDIATEHOSPITAL
Entity type:Organization
Organization Name:RUNDU INTERMEDIATEHOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:YANGAZOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:26406-626-5500
Mailing Address - Street 1:ERF 8658
Mailing Address - Street 2:RAINBOW VILLAGE
Mailing Address - City:RUNDU
Mailing Address - State:KAVANGO REGION
Mailing Address - Zip Code:9000
Mailing Address - Country:NA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:RUNDU INTERMEDIATE HOSPITAL
Practice Address - Street 2:
Practice Address - City:RUNDU
Practice Address - State:KAVANGO REGION
Practice Address - Zip Code:9000
Practice Address - Country:NA
Practice Address - Phone:2646-626-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1359
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZMPR03122281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital