COMMUNITY HEALTH ASSOCIATION OF SPOKANE NPI 1497205652

NPI Information

NPI: 1497205652
Provider Name: COMMUNITY HEALTH ASSOCIATION OF SPOKANE
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
803 S MAIN ST STE 120
MOSCOW, ID
ZIP 83843
Phone: (208) 848-8300
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COMMUNITY HEALTH ASSOCIATION OF SPOKANE is a federally qualified health center (fqhc) clinic center in Moscow, ID. COMMUNITY HEALTH ASSOCIATION OF SPOKANE NPI is 1497205652. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

803 S MAIN ST STE 120
MOSCOW, ID
ZIP 83843
Phone: (208) 848-8300
Fax: (208) 882-5587

The provider's authorized official is Aaron Wilson .
The authorized official title is Ceo and has the following contact phone number (509) 444-8888.

The enumeration date for this NPI number is 10/11/2016 and was last updated on 7/22/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1369012	OTHER	IDAHO	MEDICARE PART B PTAN

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: 11/14/2023

NPI Synchronization or Removal

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