Provider Demographics
NPI:1821420589
Name:COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Other - Org Name:ARLINGTON CHC PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-789-3717
Mailing Address - Street 1:8609 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2619
Mailing Address - Country:US
Mailing Address - Phone:425-789-3700
Mailing Address - Fax:425-789-3750
Practice Address - Street 1:326 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1652
Practice Address - Country:US
Practice Address - Phone:360-572-5454
Practice Address - Fax:360-572-5455
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-05
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF603548773336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACF60354877OtherPHARMACY LICENSE