Provider Demographics
NPI:1710496922
Name:SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:CENTRAL VALLEY VASCULAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
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 1:1005 W WALNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3384
Practice Address - Country:US
Practice Address - Phone:509-454-6545
Practice Address - Fax:509-454-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty