Provider Demographics
NPI:1093527699
Name:PUBLIC HOSPITAL DISTRICT NO 1, SKAGIT COUNTY
Entity type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT NO 1, SKAGIT COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CESENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-445-8512
Mailing Address - Street 1:1415 E KINCAID ST
Mailing Address - Street 2:ATTENTION PHARMACY
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-814-2425
Mailing Address - Fax:
Practice Address - Street 1:1400 EAST KINCAID STREET
Practice Address - Street 2:ATTENTION PHARMACY
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4127
Practice Address - Country:US
Practice Address - Phone:360-718-9782
Practice Address - Fax:360-848-4520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PUBLIC HOSPITAL DIST NO 1 SKAGIT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2308530Medicaid