NPIMap

Organization Active NPI

Grant County Public Hospital District 5

  • Community/Retail Pharmacy
  • Mattawa, WA
National Provider Identifier
1003391848
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5
Practice address
210 Government Rd
Mattawa, WA 99349-5116
Phone
(509) 932-4119
Fax
(509) 932-4086
NPI assigned
Sep 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dana S Fox
Title
Ceo
Phone
(509) 932-4499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

210 Government Rd
Mattawa, WA 99349-5116

Mailing address

PO Box 1581
Mattawa, WA 99349-0960
Phone (509) 932-4119

Other names 1

  • Mattawa Community Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grant County Public Hospital District 54 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1003391848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1581",
            "city": "MATTAWA",
            "state": "WA",
            "postal_code": "993490960",
            "telephone_number": "509-932-4119",
            "fax_number": "509-932-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GOVERNMENT RD",
            "city": "MATTAWA",
            "state": "WA",
            "postal_code": "993495116",
            "telephone_number": "509-932-4119",
            "fax_number": "509-932-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-932-4499"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mattawa Community Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mattawa Community Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mattawa, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.