NPIMap

Organization Active NPI

Yakima Valley Farm Workers Clinic

Doing business as Family Medical Center

  • Community/Retail Pharmacy
  • Walla Walla, WA
National Provider Identifier
1740376078
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF000055923 Issued in WA
Legal business name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
Family Medical Center
Practice address
1120 W Rose St
Walla Walla, WA 99362-1662
Phone
(509) 526-6967
Fax
(509) 526-6968
NPI assigned
Oct 5, 2006
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Glen Davis
Title
Coo
Phone
(509) 865-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF000055923 WA Primary

Addresses

Primary practice location

1120 W Rose St
Walla Walla, WA 99362-1662

Mailing address

2601 Commerce LN
Yakima, WA 98901-5801
Phone (509) 865-6175

Other identifiers 2

IdentifierTypeStateIssuer
6020192MedicaidWA
4925840OtherWANCPDP

Other names 1

  • Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hermiston Comm Health C57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1740376078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 COMMERCE LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989015801",
            "telephone_number": "509-865-6175",
            "fax_number": "509-865-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W ROSE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621662",
            "telephone_number": "509-526-6967",
            "fax_number": "509-526-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "509-865-6175"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF000055923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6020192",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4925840",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.