Provider Demographics
NPI:1336236272
Name:YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:MULTICARE YAKIMA MEMORIAL HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUYOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-575-8001
Mailing Address - Street 1:2811 TIETON DRIVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-575-8036
Mailing Address - Fax:509-575-8700
Practice Address - Street 1:2811 TIETON DRIVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-575-8036
Practice Address - Fax:509-575-8700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHF00001073183500000X
WAPHAR.CF.000010733336C0002X, 3336C0004X, 3336H0001X, 3336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy PharmacyGroup - Multi-Specialty
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4911702OtherNCPDP
WA1043781Medicaid
WA4911702OtherNCPDP