Provider Demographics
NPI:1356198972
Name:HOWARDS MEDICAL TRI CITIES LLC
Entity type:Organization
Organization Name:HOWARDS MEDICAL TRI CITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-834-7411
Mailing Address - Street 1:2580 YAKIMA VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-4808
Mailing Address - Country:US
Mailing Address - Phone:509-515-0200
Mailing Address - Fax:509-494-8888
Practice Address - Street 1:2580 YAKIMA VALLEY HWY
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-4808
Practice Address - Country:US
Practice Address - Phone:509-515-0200
Practice Address - Fax:509-494-8888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWARDS MEDICAL TRI CITIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment