INTERFAITH COMMUNITY HEALTH CENTER (INTERFAITH PHARMACY) - NPI NUMBER 1386089761

Summary

Provider Name: INTERFAITH COMMUNITY HEALTH CENTER (INTERFAITH PHARMACY)

NPI Number: 1386089761

Clasification: Pharmacy (3336C0002X)

Specialization: Clinic Pharmacy

Address:
220 UNITY ST
BELLINGHAM, WA
ZIP 98225

Phone Number: (360) 676-6177



Detailed Information

INTERFAITH COMMUNITY HEALTH CENTER is a clinic pharmacy pharmacy in Bellingham, WA. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. The assigned NPI number for this provider is 1386089761 and is registered as an organization entity type.
The provider Is Doing Business As Interfaith Pharmacy.

The provider's business address is:

220 UNITY ST
BELLINGHAM, WA
ZIP 98225-429
Phone: (360) 676-6177

The provider's authorized official is Desmond Skubi .
The authorized official title is Executive Director and has the following contact phone number (360) 676-6177.

The enumeration date for this NPI number is 4/30/2013 and was last updated on 4/30/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 3336C0002X Pharmacy Clinic Pharmacy No
2 3336C0003X Pharmacy Community/Retail Pharmacy Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1386089761 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name INTERFAITH COMMUNITY HEALTH CENTER The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name INTERFAITH PHARMACY Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 220 UNITY ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name BELLINGHAM The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name WA The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 982254429 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 3606766177 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 4/30/2013 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 4/30/2013 The date that a record was last updated or changed.
15 Authorized Official Last Name SKUBI The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name DESMOND The first name of the authorized official.
17 Authorized Official Title or Position EXECUTIVE DIRECTOR The title or position of the authorized official.
18 Authorized Official Telephone Number 3606766177 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 3336C0002X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 3336C0003X
22 Healthcare Provider Primary Taxonomy Switch 2 Y
23 Is Organization Subpart N

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.