1912082207 NPI number — YOKES FOOD INC

Table of content: (NPI 1912082207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912082207 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 5
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:
1912082207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2018
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:
117 N HILL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KELLOGG
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83837-2224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-682-2127
Provider Business Practice Location Address Fax Number:
208-682-3900
Provider Enumeration Date:
10/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GALLOWAY
Authorized Official First Name:
LINDSEY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHARMACY
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: 2127RP , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2020341 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8076409 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 002316600 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".