NPIMap

Organization Active NPI

Yakima Valley Farm Workers Clinic

Doing business as Yakima Valley Farm Workers Clinic - Grandview

  • Community/Retail Pharmacy
  • Grandview, WA
National Provider Identifier
1073604039
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00055922 Issued in WA
Legal business name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
Yakima Valley Farm Workers Clinic - Grandview
Practice address
1000 Wallace Way
Grandview, WA 98930-8805
Phone
(509) 882-3977
Fax
(509) 882-2966
NPI assigned
Sep 27, 2006
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Glen Davis
Title
Coo
Phone
(509) 865-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00055922 WA Primary

Addresses

Primary practice location

1000 Wallace Way
Grandview, WA 98930-8805

Mailing address

2601 Commerce LN
Yakima, WA 98901-5801
Phone (509) 865-6175

Other identifiers 2

IdentifierTypeStateIssuer
6008940MedicaidWA
4915558OtherWANCPDP

Other names 1

  • Yakima Valley Farm Workers Clinic - Grandview Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Yvfwc Hermiston Comm HL57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1073604039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 COMMERCE LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989015801",
            "telephone_number": "509-865-6175",
            "fax_number": "509-865-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-882-3977",
            "fax_number": "509-882-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "509-865-6175"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00055922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008940",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4915558",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yakima Valley Farm Workers Clinic - Grandview",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Yakima Valley Farm Workers Clinic - Grandview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grandview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.