NPIMap

Organization Active NPI

Columbia Basin Health Association

Doing business as Connell Pharmacy

  • Pharmacist
  • Connell, WA
National Provider Identifier
1629311436
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
CF60349261 Issued in WA
Legal business name
COLUMBIA BASIN HEALTH ASSOCIATION
Doing business as
Connell Pharmacy
Practice address
1051 Columbia Avenue
Connell, WA 99326-8702
Phone
(509) 234-0866
Fax
(509) 488-9939
NPI assigned
Mar 29, 2013
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Nieves Gomez
Title
Ceo
Phone
(509) 488-5256

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X CF60349261 WA Primary
Durable Medical Equipment & Medical Supplies 332B00000X CF60349261 WA

Addresses

Primary practice location

1051 Columbia Avenue
Connell, WA 99326-8702

Mailing address

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Other names 1

  • Connell Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040209000250 WA Part B Supplier - Clinic/Group Practice 4486564309 Receives reassigned benefits from 95 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Connell, WA; Mattawa, WA; Othello, WA; Pasco, WA; Royal City, WA
O20150511001897 WA DME Supplier - Pharmacy 4486564309 Practice locations: Connell, WA

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Columbia Basin Health Assoc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Columbia Basin Health AssociationPasco, WA, CCN 501042 Federally qualified health center Operational/Managerial Control (100%) Mar 18, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1629311436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 COLUMBIA AVENUE",
            "city": "CONNELL",
            "state": "WA",
            "postal_code": "993268702",
            "telephone_number": "509-234-0866",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA BASIN HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-29",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "NIEVES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-488-5256"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "CF60349261",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "CF60349261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connell Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Connell, WA

Sources for this page

Verify at the official NPI Registry.