Organization
COUNCIL ON AGING & HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT HALLETT (NUTRITION PROGRAM DIRECTOR)
(509) 397-4611
Entity
Organization
Contact information
Practice address
210 S MAIN ST, COLFAX, WA 99111-1820
(509) 394-4611
(509) 397-2917
Mailing address
210 S MAIN ST, PO BOX 107, COLFAX, WA 99111-1820
(509) 394-4611
(509) 397-2917
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051992
SSPS - COPES
WA
05
—
9030859
—
WA
Enumeration date
06/22/2007
Last updated
08/22/2020
Update your record
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