Tieton Village Drug
LBN: Tieton Village Drug Inc.
Tieton Village Drug is an health care organization with primary practice located at 3708 Tieton Dr , Yakima WA 98902-3664. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Tieton Village Drug Inc. can be contacted via phone (509) 966-6850, or through Davis, Ryan via phone (509) 469-3198.
Contact Information
Primary practice address
3708 Tieton Dr
Yakima WA 98902-3664
Phone: (509) 966-6850
Fax: (509) 966-2690
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Pharmacy | 333600000X | ||
Suppliers / Community/Retail Pharmacy | 3336C0003X | CF00056158 | Washington |
Profile Details
NPI number | 1659450336 |
---|---|
LBN Legal business name | Tieton Village Drug Inc. |
DBA Doing business as | Tieton Village Drug |
Authorized official | Davis, Ryan |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Nov 3rd, 2006 |
Last updated | Sep 18th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1659450336 | NPPES |
Other | 2106408 | PK | |
MEDICAID | 6712209 | PK |
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