Organization
FAMILY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS HERNANDEZ (CEO)
(509) 422-5700
Entity
Organization
Contact information
Practice address
525 WEST JAY, BREWSTER, WA 98812-9701
(509) 689-3455
(509) 689-2104
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
(509) 422-5700
(509) 422-7680
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
CF00057266
WA
3336C0002X
Clinic Pharmacy
Primary
CF00057266
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4929836
NCPDP
—
Enumeration date
12/12/2006
Last updated
01/19/2021
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