NPIMap

Organization Active NPI

David C Wynecoop Memorial Clinic Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Wellpinit, WA
National Provider Identifier
1750411310
Registry record updated Mar 7, 2023
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
DAVID C WYNECOOP MEMORIAL CLINIC PHARMACY
Practice address
Agency Square
Wellpinit, WA 99040
Phone
(509) 258-4517
Fax
(509) 258-7152
NPI assigned
Mar 6, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
David Battese
Title
Area Business Office Coordinator
Phone
(503) 326-7277

Specialties & licenses 1

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

Addresses

Primary practice location

Agency Square
Wellpinit, WA 99040

Mailing address

Agency Square
PO Box 357
Wellpinit, WA 99040
Phone (509) 258-4517

Other identifiers 2

IdentifierTypeStateIssuer
6021166MedicaidWA
4926309OtherNCPDP NUMBER

Other names 1

  • Wellpinit Service Unit Other name

National Provider Directory

National Provider Directory
Tax ID family
David C Wynecoop Memorial Clinic4 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": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1750411310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AGENCY SQUARE",
            "address_2": "PO BOX 357",
            "city": "WELLPINIT",
            "state": "WA",
            "postal_code": "99040",
            "telephone_number": "509-258-4517",
            "fax_number": "509-258-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AGENCY SQUARE",
            "city": "WELLPINIT",
            "state": "WA",
            "postal_code": "99040",
            "telephone_number": "509-258-4517",
            "fax_number": "509-258-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C WYNECOOP MEMORIAL CLINIC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BATTESE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AREA BUSINESS OFFICE COORDINATOR",
        "authorized_official_telephone_number": "503-326-7277"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6021166",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "4926309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellpinit Service Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wellpinit, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.