Provider Demographics
NPI:1164026001
Name:AHHPC CORP
Entity Type:Organization
Organization Name:AHHPC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WON
Authorized Official - Middle Name:
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-899-0319
Mailing Address - Street 1:907 W BOONE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2503
Mailing Address - Country:US
Mailing Address - Phone:509-822-8060
Mailing Address - Fax:240-331-0092
Practice Address - Street 1:504 S 17TH ST STE B
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5217
Practice Address - Country:US
Practice Address - Phone:509-822-8060
Practice Address - Fax:240-331-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty