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LAKE ROOSEVELT COMMUNITY HEALTH CENTERS NPI 1073776936


NPI Information

NPI: 1073776936
Provider Name: LAKE ROOSEVELT COMMUNITY HEALTH CENTERS

Former Legal Business Name: COLVILLE NATIONS COMMUNITY HEALTH CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 50D1035815

Address:
39 SHORT CUT ROAD
INCHELIUM, WA
ZIP 99138
Phone: (509) 722-7610
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LAKE ROOSEVELT COMMUNITY HEALTH CENTERS is a family medicine in Inchelium, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKE ROOSEVELT COMMUNITY HEALTH CENTERS NPI is 1073776936. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Colville Nations Community Health Center.

The provider's business location address is:

39 SHORT CUT ROAD
INCHELIUM, WA
ZIP 99138-290
Phone: (509) 722-7610

The provider's authorized official is Bill Foxcroft .
The authorized official title is Executive Director and has the following contact phone number (509) 722-7610.

The CLIA number assigned to this NPI record is 50D1035815 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/9/2008 and was last updated on 7/9/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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