Active NPI
David C Wynecoop Memorial Health Center Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Wellpinit, WA
National Provider Identifier
1699579979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Legal business name
- DAVID C WYNECOOP MEMORIAL HEALTH CENTER PHARMACY
- Practice address
- 6203 Agency Loop Road
Wellpinit, WA 99040 - Phone
- (509) 258-4517
- Fax
- (509) 258-6913
- NPI assigned
- Apr 3, 2025
- Last updated
- May 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jeremy Burtenshaw
- Title
- Chief Pharmacist
- Phone
- (509) 258-4517
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | NU | Primary |
Addresses
Primary practice location
6203 Agency Loop Road
Wellpinit, WA 99040
Mailing address
PO Box 357
Wellpinit, WA 99040-0357
Phone (509) 258-4517
Other names 1
- Wellpinit Indian Health Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- David C Wynecoop Memorial Health Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba David C. Wynecoop Memorial Health Center
- Federally Qualified Health Center (FQHC)
- Wellpinit, WA
- NPI 1508660879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746489600000",
"number": "1699579979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 357",
"city": "WELLPINIT",
"state": "WA",
"postal_code": "990400357",
"telephone_number": "509-258-4517",
"fax_number": "509-418-5767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6203 AGENCY LOOP ROAD",
"city": "WELLPINIT",
"state": "WA",
"postal_code": "99040",
"telephone_number": "509-258-4517",
"fax_number": "509-258-6913"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVID C WYNECOOP MEMORIAL HEALTH CENTER PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2025-04-03",
"last_updated": "2025-05-06",
"certification_date": "2025-05-06",
"status": "A",
"authorized_official_last_name": "BURTENSHAW",
"authorized_official_first_name": "JEREMY",
"authorized_official_title_or_position": "CHIEF PHARMACIST",
"authorized_official_telephone_number": "509-258-4517",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332800000X",
"taxonomy_group": "",
"desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Wellpinit Indian Health Pharmacy",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Wellpinit Indian Health Pharmacy",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Wellpinit, WA
- Ann Christine Dahl, CDP
- David C Wynecoop Memorial Clinic
- David C Wynecoop Memorial Clinic DHHS IHS Wellpinit Service Unit
- David C Wynecoop Memorial Clinic DHHS IHS Wellpinit Service Unit (Wellpinit Service Unit)
- David C Wynecoop Memorial Clinic Pharmacy
- Lee Roy Arrogante Esposo, PHARMD
- Joelena Marie Ford, CPSST
- Vincent John Frattali, D. D. S.
- Phyllis Lorraine Grant, LMHC
- Robert Joseph Hayward, CDPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.