Organization
DAVID C WYNECOOP MEMORIAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM N WILES (ADMINISTRATIVE OFFICER)
(509) 258-4517
Entity
Organization
Contact information
Practice address
6203 AGENCY LOOP ROAD, WELLPINIT, WA 99040-0357
(509) 258-4517
(509) 258-7152
Mailing address
6203 AGENCY LOOP ROAD, WELLPINIT, WA 99040-0357
(509) 258-4517
(509) 258-7152
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4926309
NCPDP NUMBER
WA
01
—
PH00044329
LICENSE
WA
01
—
PH00052198
LICENSE
WA
Enumeration date
01/04/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us