1205860244 NPI number — YOKES FOOD INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205860244 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 11
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:
1205860244
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 FOODS INC
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:
9329 E MONTGOMERY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-4295
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-343-3379
Provider Business Practice Location Address Fax Number:
509-242-1764
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.00057171 , 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: 2107412 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6025282 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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