NPIMap

Organization Active NPI

Colville Nation Community Health Centers

Doing business as Lake Roosevelt Community Health Centers Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Keller, WA
National Provider Identifier
1487779369
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
COLVILLE NATION COMMUNITY HEALTH CENTERS
Doing business as
Lake Roosevelt Community Health Centers Pharmacy
Practice address
11665 South Highway 21
Keller, WA 99140
Phone
(509) 634-7300
Fax
(509) 722-7021
NPI assigned
Mar 20, 2007
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Sue Burkhart
Title
Biller
Phone
(509) 722-7006

Specialties & licenses 1

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

Addresses

Primary practice location

11665 South Highway 21
Keller, WA 99140

Mailing address

P.O. Box 290
Inchelium, WA 99140-0290
Phone (509) 634-7300

Other names 2

  • LAKE ROOSEVELT COMMUNITY HEALTH CENTERS PHARMACY Doing business as
  • CNCHC SANPOIL VALLY COMMUNITY HEALTH CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Colville Nation Community4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1487779369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 290",
            "city": "INCHELIUM",
            "state": "WA",
            "postal_code": "991400290",
            "telephone_number": "509-634-7300",
            "fax_number": "509-722-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 SOUTH HIGHWAY 21",
            "city": "KELLER",
            "state": "WA",
            "postal_code": "99140",
            "telephone_number": "509-634-7300",
            "fax_number": "509-722-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLVILLE NATION COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BURKHART",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "509-722-7006"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE ROOSEVELT COMMUNITY HEALTH CENTERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CNCHC SANPOIL VALLY COMMUNITY HEALTH CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CNCHC SANPOIL VALLY COMMUNITY HEALTH CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Keller, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.