Organization
MEDICAL CENTER
Active
Other names
MEDICINE MART
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD HESTER PPH (PRES)
(509) 453-4835
Entity
Organization
Contact information
Practice address
1112 W SPRUCE ST, YAKIMA, WA 98902-3210
(509) 453-4835
(509) 453-7691
Mailing address
1112 W SPRUCE ST, YAKIMA, WA 98902-3210
(509) 453-4835
(509) 453-7691
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00002290
WA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4910471
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6130801
—
WA
Enumeration date
09/12/2006
Last updated
06/10/2011
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