NPIMap

Organization Active NPI

Community Health Center of Snohomish County

  • Clinic Pharmacy
  • Lynnwood, WA
National Provider Identifier
1003948738
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
CF00057233 Issued in WA
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Practice address
4111 194TH St SW
Suite 300
Lynnwood, WA 98036-4604
Phone
(425) 835-5202
Fax
(425) 835-5203
NPI assigned
Mar 9, 2007
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTYAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. Robert M Farrell
Title
Chief Executive Officer
Phone
(425) 789-3700

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 27

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

View all 27

Practitioners 84

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 84

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Lynnwood Pharmacy4111 194TH St SW, Lynnwood, WA 98036-4604(425) 835-5251 Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Jan 1, 1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20221107003052 WA DME Supplier - Pharmacy 0446152003 Practice locations: Lynnwood, WA

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center (28 organizations share this tax ID)
Part of
Community Health Center

Locations

4111 194th St SW
Ste 300
Lynnwood, WA 98036
Phone (425) 835-5202

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X CF00057233 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

4111 194TH St SW
Suite 300
Lynnwood, WA 98036-4604

Mailing address

8609 Evergreen Way
Everett, WA 98208-2619
Phone (425) 789-3700

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
6026488MedicaidWA

Other names 1

NPPES NPI Registry
  • Community Health Center of Snohomish County Lynnwood Pharmacy Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 16, 2022.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1003948738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082619",
            "telephone_number": "425-789-3700",
            "fax_number": "425-789-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "address_2": "SUITE 300",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-835-5202",
            "fax_number": "425-835-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "425-789-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "CF00057233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6026488",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Snohomish County Lynnwood Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Community Health Center of Snohomish County Lynnwood Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.