Provider Demographics
NPI:1891982237
Name:BATES DRUG STORES, INC.
Entity Type:Organization
Organization Name:BATES DRUG STORES, INC.
Other - Org Name:BATES QUICK CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-489-4500
Mailing Address - Street 1:3704 N NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2968
Mailing Address - Country:US
Mailing Address - Phone:509-489-4500
Mailing Address - Fax:509-489-4330
Practice Address - Street 1:3704 N NEVADA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2968
Practice Address - Country:US
Practice Address - Phone:509-489-4500
Practice Address - Fax:509-489-4330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BATES DRUG STORES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty