Organization
COLUMBIA BASIN HEALTH ASSOCIATION
Active
Other names
Wahluke Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA BUNCH (CFO)
(509) 488-5250
Entity
Organization
Contact information
Practice address
601 GOVERNMENT WAY, MATTAWA, WA 99349
(509) 932-3535
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
CF00056507
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135012
DEPT L&I #
WA
01
—
4927337
NABP #
WA
05
—
6022537
—
WA
01
—
CF00056507
STATE STORE LICENSE
WA
01
—
CF56507
STATE CONTROLLED SBSTNC #
WA
01
—
CH10046A
340B ID#
WA
Enumeration date
02/07/2007
Last updated
03/07/2023
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