Provider Demographics
NPI:1629505607
Name:SPOKANE VALLEY MEDICAL, INC
Entity Type:Organization
Organization Name:SPOKANE VALLEY MEDICAL, INC
Other - Org Name:VALLEY MISSION HOMECARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:509-928-6400
Mailing Address - Street 1:12509 E. MISSION AVE.
Mailing Address - Street 2:SUITE #103
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-928-6400
Mailing Address - Fax:509-928-6441
Practice Address - Street 1:12509 E. MISSION AVE
Practice Address - Street 2:SUITE #103
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99216
Practice Address - Country:US
Practice Address - Phone:509-928-6400
Practice Address - Fax:509-928-6441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies