Provider Demographics
NPI:1407106883
Name:SUNNYSIDE COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SUNNYSIDE COMMUNITY HOSPITAL
Other - Org Name:VALLEY REGIONAL BONE AND JOINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWAN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:509-837-1655
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:509-837-1617
Mailing Address - Fax:509-837-4908
Practice Address - Street 1:1413 EAST EDISON AVE.
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-1622
Practice Address - Country:US
Practice Address - Phone:509-837-1617
Practice Address - Fax:509-837-4908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNNYSIDE COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-13
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty