1336194893 NPI number — EMPIRE HEALTH SERVICES

Table of content: (NPI 1336194893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336194893 NPI number — EMPIRE HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPIRE HEALTH SERVICES
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:
DEACONESS MEDICAL CENTER
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:
1336194893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2148
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99210-2148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-458-5800
Provider Business Mailing Address Fax Number:
509-473-4050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 W 5TH AVE
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:
99204-2803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-458-5800
Provider Business Practice Location Address Fax Number:
509-473-4050
Provider Enumeration Date:
05/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COLLETT
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR PATIENT FINANCIAL SERVICES
Authorized Official Telephone Number:
509-473-4694

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H-037 , 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: 7039506 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7071731 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7072101 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3305604 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".