NPIMap

Organization Active NPI

Kennewick General Hosital

  • Community/Retail Pharmacy
  • Kennewick, WA
National Provider Identifier
1619090487
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF000056883 Issued in WA
Legal business name
KENNEWICK GENERAL HOSITAL
Doing business as
The Pharmacy at Trios Southridge
Practice address
521 N Young St
Kennewick, WA 99336-7806
Phone
(509) 221-6150
Fax
(509) 221-6151
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
Michael Porter
Title
Phcy Manager
Phone
(509) 221-7351

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X CF000056883 WA Primary

Addresses

Primary practice location

521 N Young St
Kennewick, WA 99336-7806

Mailing address

3730 Plaza Way
Kennewick, WA 99338-2718
Phone (509) 221-6150

Other identifiers 2

IdentifierTypeStateIssuer
2107413OtherPK
6025795MedicaidWA

Other names 1

  • The Pharmacy at Trios Southridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennewick General Hosp-7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

3730 Plaza Way
Kennewick, WA 99338
Phone (509) 221-6350

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1619090487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 PLAZA WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-221-6150",
            "fax_number": "509-221-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N YOUNG ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367806",
            "telephone_number": "509-221-6150",
            "fax_number": "509-221-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEWICK GENERAL HOSITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHCY MANAGER",
        "authorized_official_telephone_number": "509-221-7351"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF000056883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2107413",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6025795",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pharmacy at Trios Southridge",
            "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 Sep 14, 2016; 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.