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General NPI Number Information
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NPI Number | 1225276264
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Entity Type | Organization
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Legal Business Name | SPOKANE VALLEY MEDICAL, INC.
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 12509 E MISSION AVE STE 103
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1061
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Country | US
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Telephone | 509-928-6400
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Fax | 509-928-6441
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Provider Business Mailing Address
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Address Line | 509 N SULLIVAN RD # C320
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City | SPOKANE VALLEY
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State | WA
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Zip | 99037-8531
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Country | US
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Telephone | 509-928-6400
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Fax | 509-928-6441
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Authorized Official
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Title or Position | PHARMACIST MANAGER
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Name | DAVID M. REDMOND
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Credential | RPH
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Telephone | 509-928-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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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