Provider Demographics
NPI: | 1588349856 |
---|---|
Name: | CENTRAL WASHINGTON HEALTH SERVICES ASSOCATION |
Entity type: | Organization |
Organization Name: | CENTRAL WASHINGTON HEALTH SERVICES ASSOCATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHARMACY MANAGER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | CYNTHIA |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | POTTS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RPH |
Authorized Official - Phone: | 509-433-3030 |
Mailing Address - Street 1: | 1201 S MILLER ST |
Mailing Address - Street 2: | |
Mailing Address - City: | WENATCHEE |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98801-3201 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 509-433-3030 |
Mailing Address - Fax: | 509-433-3008 |
Practice Address - Street 1: | 102 CAMELIA ST NW |
Practice Address - Street 2: | |
Practice Address - City: | ROYAL CITY |
Practice Address - State: | WA |
Practice Address - Zip Code: | 99357 |
Practice Address - Country: | US |
Practice Address - Phone: | 509-764-6447 |
Practice Address - Fax: | 509-764-6435 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2023-06-15 |
Last Update Date: | 2023-06-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3336C0002X | Suppliers | Pharmacy | Clinic Pharmacy |