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Department of Health and Human Services

Organization Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Nespelem, WA

NPI 1265556005 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1265556005
Entity type
Organization (NPI type 2)
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Legal business name
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Practice address
29 Nespelem San Poil Street
Nespelem, WA 99155-0071
Phone
(509) 634-2900
Fax
(509) 634-2990
NPI assigned
Mar 19, 2007
Organization subpart
No

Authorized official

Name
Yvonne L Misiaszek
Title
Chief Executive Officer
Phone
(509) 634-2900

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Omak Health Station Pharmacy (5 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Yes

Addresses

Primary practice location

29 Nespelem San Poil Street
Nespelem, WA 99155-0071

Mailing address

29 Nespelem San Poil Street
Nespelem, WA 99155-0071
Phone (509) 634-2900

Other identifiers

IdentifierTypeStateIssuer
6021141MedicaidWA

Other names

  • COLVILLE INDIAN HEALTH 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 Aug 22, 2020.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265556005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NESPELEM SAN POIL STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550071",
            "telephone_number": "509-634-2900",
            "fax_number": "509-634-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 NESPELEM SAN POIL STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550071",
            "telephone_number": "509-634-2900",
            "fax_number": "509-634-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH AND HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MISIASZEK",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "509-634-2900"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6021141",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLVILLE INDIAN HEALTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nespelem, WA

All providers in Nespelem, WA · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Washington

Sources for this page

Verify at the official NPI Registry.