Provider Demographics
NPI:1033355599
Name:YAKIMA VALLEY FARM WORKERS CLINIC
Entity Type:Organization
Organization Name:YAKIMA VALLEY FARM WORKERS CLINIC
Other - Org Name:YVFWC SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY ASSOC. CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUDAK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:509-374-7113
Mailing Address - Street 1:2601 COMMERCE LN
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-5801
Mailing Address - Country:US
Mailing Address - Phone:509-865-6175
Mailing Address - Fax:877-856-9819
Practice Address - Street 1:2601 COMMERCE LN
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-5801
Practice Address - Country:US
Practice Address - Phone:509-865-6175
Practice Address - Fax:877-856-9819
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YAKIMA VALLEY FARM WORKERS CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-05
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy