Healthcare Provider Details

I. General information

NPI: 1225165509
Provider Name (Legal Business Name): CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S MILLER ST
WENATCHEE WA
98801-3201
US

IV. Provider business mailing address

PO BOX 361
WENATCHEE WA
98807-0361
US

V. Phone/Fax

Practice location:
  • Phone: 509-662-1511
  • Fax:
Mailing address:
  • Phone: 509-662-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPF00057711
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHAR.CF.00057711
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHAR.CF.00057711
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHAR.CF.00057711
License Number StateWA

VIII. Authorized Official

Name: ANDREW JONES
Title or Position: CFO
Credential:
Phone: 509-663-8711