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General NPI Number Information
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NPI Number | 1134831415
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Entity Type | Organization
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Legal Business Name | PEND OREILLE COUNTY PUBLIC HOSPITAL DISTRICT NO 1
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 336 S WASHINGTON AVE
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City | NEWPORT
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State | WA
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Zip | 99156-9671
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Country | US
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Telephone | 509-447-2484
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Fax | 509-447-2485
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Provider Business Mailing Address
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Address Line | 714 W PINE ST
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City | NEWPORT
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State | WA
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Zip | 99156-9046
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Country | US
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Telephone | 509-447-9363
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Fax | 509-447-2485
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Authorized Official
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Title or Position | CEO
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Name | KIM M MANUS
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Credential |
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Telephone | 509-447-9310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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