Colville Medical Center

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

PHARCF00056735 Issued in WA

Legal business name

COLVILLE MEDICAL CENTER

Doing business as

NORTHEAST WASHINGTON MED GROUP PHCY

Practice address

1200 E Columbia Ave
Colville, WA 99114-3354

Phone

(509) 684-7727

Fax

(509) 684-7711

NPI assigned

Oct 12, 2005

Organization subpart

No

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

Authorized official

Name

Julie Kaschmitter

Title

Dir of Pharmacy

Phone

(509) 684-7727

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NORTHEAST WASHINGTON MED GROUP PHCY Doing business as

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345680000000",
    "number": "1841288941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E COLUMBIA AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991143354",
            "telephone_number": "509-684-7727",
            "fax_number": "509-684-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E COLUMBIA AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991143354",
            "telephone_number": "509-684-7727",
            "fax_number": "509-684-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLVILLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-08-23",
        "status": "A",
        "authorized_official_last_name": "KASCHMITTER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "DIR OF PHARMACY",
        "authorized_official_telephone_number": "509-684-7727"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "PHARCF00056735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6022735",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4926436",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST WASHINGTON MED GROUP PHCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic Pharmacy in Colville, WA
• Providers in Colville, WA by specialty
• Clinic Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; 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.