Pullman Regional Hospital Clinic Network LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

50-3922 Issued in WA

Legal business name

PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

Doing business as

Palouse Pediatrics - Pullman

Practice address

1205 SE Pro Mall Blvd Ste 104
Pullman, WA 99163-5423

Phone

(509) 332-6139

Fax

(509) 332-6579

NPI assigned

May 4, 2009

Organization subpart

No

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

Authorized official

Name

Steven Febus

Title

Cfo

Phone

(509) 332-6139

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Palouse Pediatrics - Pullman Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Public Hospital District #1-a of Whitman County

  dba Pullman Regional Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Pullman, WA
  • NPI 1750401006

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1063646107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 SE BISHOP BLVD STE 101",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635502",
            "telephone_number": "509-332-6139",
            "fax_number": "509-332-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SE PRO MALL BLVD STE 104",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-6139",
            "fax_number": "509-332-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "FEBUS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-332-6139"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": "50-3922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8891113",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CERTIFICATION",
            "identifier": "50-3922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palouse Pediatrics - Pullman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pullman Family Dentistry PLLC
• Pullman Family Medicine
• Pullman Nursing & Rehab LLC (Pullman Care)
• Pullman Regional Hospital
• Pullman Regional Hospital
• Pullman Regional Hospital Clinic Network, LLC (Palouse ENT)
• Pullman School District No.267
• Pullman Sports Physical Therapy, Inc
• Pullman Urgent Care PLLC
• Pullman Vision Source

• Rural Health Clinic/Center in Pullman, WA
• Providers in Pullman, WA by specialty
• Rural Health Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.