Provider Demographics
NPI: | 1922525666 |
---|---|
Name: | SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION |
Entity Type: | Organization |
Organization Name: | SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION |
Other - Org Name: | SHC MEDICAL CENTER YAKIMA |
Other - Org Type: | Other Name |
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: | 509-837-1356 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 110 S 9TH AVE |
Practice Address - Street 2: | |
Practice Address - City: | YAKIMA |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98902-3315 |
Practice Address - Country: | US |
Practice Address - Phone: | 509-595-5102 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-08-24 |
Last Update Date: | 2017-09-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2083X0100X | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | Group - Multi-Specialty |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
No | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty |