1972537900 NPI number — YOKES FOOD INC

Table of content: (NPI 1972537900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972537900 NPI number — YOKES FOOD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOKES FOOD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
YOKES PHARMACY 9
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972537900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
YOKES PHARMACY
Provider Second Line Business Mailing Address:
PO BOX 141268
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-921-2292
Provider Business Mailing Address Fax Number:
509-343-1117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3321 W INDIAN TRAIL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-4762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-8720
Provider Business Practice Location Address Fax Number:
509-325-7625
Provider Enumeration Date:
07/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GALLOWAY
Authorized Official First Name:
LINDSEY
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY DIRECTOR
Authorized Official Telephone Number:
509-921-2292

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHAR.CF.00005299 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6016638 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2110272 . This is a "PK" identifier . This identifiers is of the category "OTHER".