NPIMap

Organization Active NPI

Yakim Valley Farm Workers Clinic

Doing business as Miramar Health Center Kennewick Pharmacy

  • Community/Retail Pharmacy
  • Kennewick, WA
National Provider Identifier
1194315002
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
YAKIM VALLEY FARM WORKERS CLINIC
Doing business as
Miramar Health Center Kennewick Pharmacy
Practice address
6351 W Rio Grande Ave
Kennewick, WA 99336-7634
Phone
(509) 579-4791
Fax
(509) 579-5907
NPI assigned
Jan 25, 2021
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
YAKIM VALLEY FARM WORKERS CLINICAs reported in NPPES

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 Primary

Addresses

Primary practice location

6351 W Rio Grande Ave
Kennewick, WA 99336-7634

Mailing address

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

Other names 1

  • Miramar Health Center Kennewick Pharmacy Doing business as

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

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": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1194315002",
    "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": "6351 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367634",
            "telephone_number": "509-579-4791",
            "fax_number": "509-579-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIM VALLEY FARM WORKERS CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YAKIM VALLEY FARM WORKERS CLINIC",
        "enumeration_date": "2021-01-25",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miramar Health Center Kennewick Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Miramar Health Center Kennewick Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, 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.