Sunnyside Community Hospital Association
Organization Active NPI Rural Health Clinic/Center · Union Gap, WA
NPI 1154861847 · NPPES record last updated Oct 10, 2024
Key facts
- NPI
- 1154861847
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
- Practice address
- 1420 Ahtanum Ridge Dr
Union Gap, WA 98903-1839 - Phone
- (509) 454-7700
- Fax
- (509) 454-7710
- NPI assigned
- Mar 1, 2017
- Organization subpart
- No
Authorized official
- Name
- Mathew Mathiesen
- Title
- Cfo
- Phone
- (509) 837-1617
Other NPIs on the same Medicare enrollment 30
Corporate family (same tax ID) 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040227000194 | WA | Part B Supplier - Clinic/Group Practice | 1658280896 |
Receives reassigned benefits from 139 practitioners 30 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Zillah, WA; Yakima, WA; Union Gap, WA; Toppenish, WA; Sunnyside, WA; Prosser, WA; Grandview, WA |
National Provider Directory
- Tax ID family
- Sunnyside Community Hos
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1420 Ahtanum Ridge Dr
Union Gap, WA 98903-1839
Mailing address
PO Box 719
Sunnyside, WA 98944-0719
Phone (509) 454-7700
Other names
- Astria Health Center
Other providers in Union Gap, WA
- Betty Simmons
- Melissa Sixberry
- Keisha Smith
- Lloyd D Smith
- Robin K Spooner
- Sunnyside Community Hospital Association
- Jennifer T Thayer
- Matthew James Thomas
- Derek C Thompson
- Carla Alexandra Trevino
All providers in Union Gap, WA · Rural Health Clinic/Center in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.