| |
315 Martin Luther King Jr Way Tacoma WA 98405-4234 | |
(253) 403-1000 | |
Not Available |
Full Name | |
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Speciality | General Acute Care Hospital |
Location | 315 Martin Luther King Jr Way, Tacoma, Washington |
Authorized Official Name and Position | William Glenn Robertson (CEO) |
Authorized Official Contact | 2534031272 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 5299 Ms: 820-5-pco Tacoma WA 98415-0299 Ph: () - | 315 Martin Luther King Jr Way Tacoma WA 98405-4234 Ph: (253) 403-1000 |
NPI Number | 1366556227 |
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Provider Enumeration Date | 08/18/2006 |
Last Update Date | 08/08/2024 |
Certification Date | 08/08/2024 |
Medicare PECOS PAC ID | 7719899897 |
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Medicare Enrollment ID | O20031208000458 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366556227 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
282N00000X | General Acute Care Hospital | (Washington) | Primary |
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