NPIMap

Community Health Center of Snohomish County

Organization Active NPI Clinic Pharmacy · Everett, WA

NPI 1124150859 · NPPES record last updated Jul 14, 2014

Key facts

NPI
1124150859
Entity type
Organization (NPI type 2)
Primary specialty
Clinic Pharmacy 3336C0002X
License
CF00056988 (WA)
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Practice address
1424 Broadway
Everett, WA 98201-1720
Phone
(425) 789-2050
Fax
(425) 789-2070
NPI assigned
Mar 9, 2007
Organization subpart
Yes
Parent organization (as reported)
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY

Authorized official

Name
Mr. Robert M Farrrell
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

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Everett North Pharmacy
1424 Broadway, Everett, WA 98201-1720 · (425) 789-2098		 Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignment
Participating since Jan 1, 1998

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20221107002982 WA DME Supplier - Pharmacy 0446152003 Practice locations: Everett, WA

National Provider Directory

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X CF00056988 WA Yes

Addresses

Primary practice location

1424 Broadway
Everett, WA 98201-1720

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
6024780MedicaidWA

Other names

  • Community Health Center of Snohomish County Everett-North Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 14, 2014.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1124150859",
    "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": "1424 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011720",
            "telephone_number": "425-789-2050",
            "fax_number": "425-789-2070"
        }
    ],
    "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": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "FARRRELL",
        "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": "CF00056988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6024780",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Snohomish County Everett-North Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

All providers in Everett, WA · Clinic Pharmacy in Washington

Sources for this page

Verify at the official NPI Registry.