Healthcare Provider Details

I. General information

NPI: 1720744337
Provider Name (Legal Business Name): TRI CITIES COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date: 04/24/2023
Reactivation Date: 12/05/2023

III. Provider practice location address

515 W COURT ST
PASCO WA
99301-3737
US

IV. Provider business mailing address

PO BOX 1452
PASCO WA
99301-1223
US

V. Phone/Fax

Practice location:
  • Phone: 509-547-2204
  • Fax: 509-542-8836
Mailing address:
  • Phone: 509-547-2204
  • Fax: 509-542-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KRISTY NEEDHAM
Title or Position: CEO
Credential:
Phone: 509-547-2204