NPIMap

Organization Active NPI

International Community Health Services

  • Community/Retail Pharmacy
  • Seattle, WA
National Provider Identifier
1942333422
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF.60114707 Issued in WA
Legal business name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Practice address
720 8TH Ave S
Seattle, WA 98114-3007
Phone
(206) 788-3770
Fax
(206) 788-3705
NPI assigned
Mar 13, 2007
Last updated
Mar 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERNATIONAL COMMUNITY HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Hermes Shahbazian
Title
Cfo
Phone
(206) 788-3618

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Community/Retail Pharmacy 3336C0003X CF00056068 WA
Community/Retail Pharmacy 3336C0003X CF.60114707 WA Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

720 8TH Ave S
Seattle, WA 98114-3007

Mailing address

P.O. Box 3007
Seattle, WA 98114-3007
Phone (206) 788-3770

Other identifiers 1

IdentifierTypeStateIssuer
6019293MedicaidWA

Other names 1

  • ID Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210129000988 WA Part B Supplier - Mass Immunization (Roster Biller Only) 5799695672 2 other NPIs on this enrollment
Practice locations: Seattle, WA; Shoreline, WA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
International District33 organizations share this tax ID, including this one
Part of
International District

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ichs Bellevue Medical and Dental ClinicBellevue, WA, CCN 501971 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2014
May 1, 2014
Ichs Shoreline Medical and Dental ClinicShoreline, WA, CCN 501974 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 15, 2014
Sep 15, 2014
Ichs International District Vision ClinicSeattle, WA, CCN 941034 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 15, 2017
Sep 15, 2017
Ichs Sound Auburn Medical ClinicAuburn, WA, CCN 501074 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2025
May 1, 2025

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1942333422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3007",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143007",
            "telephone_number": "206-788-3770",
            "fax_number": "206-788-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 8TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143007",
            "telephone_number": "206-788-3770",
            "fax_number": "206-788-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERNATIONAL COMMUNITY HEALTH SERVICES",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "SHAHBAZIAN",
        "authorized_official_first_name": "HERMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "206-788-3618"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00056068",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF.60114707",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6019293",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ID Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ID Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.