NPIMap

Organization Active NPI

Tieton Village Drug

  • Durable Medical Equipment & Medical Supplies
  • Yakima, WA
National Provider Identifier
1780748889
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TIETON VILLAGE DRUG
Practice address
3708 Tieton Dr
Yakima, WA 98902-3664
Phone
(509) 966-6850
Fax
(509) 966-2690
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Philip Edward Luther
Title
Owner
Phone
(509) 966-6850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3708 Tieton Dr
Yakima, WA 98902-3664

Mailing address

3708 Tieton Dr
Yakima, WA 98902-3664
Phone (509) 966-6850

National Provider Directory

National Provider Directory
Tax ID family
Tieton Village Drug5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780748889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023664",
            "telephone_number": "509-966-6850",
            "fax_number": "509-966-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023664",
            "telephone_number": "509-966-6850",
            "fax_number": "509-966-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIETON VILLAGE DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUTHER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-966-6850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.