Provider Demographics
NPI:1134648546
Name:SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:CENTRAL WASHINGTON OCCUPATIONAL MEDICINE - TOPPENISH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-837-1356
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-0719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:516 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1616
Practice Address - Country:US
Practice Address - Phone:509-865-1555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine