| Sunnyside Medical | |
|
617 Scoon Rd Sunnyside WA 98944-1031 | |
| (509) 454-4143 | |
| (509) 454-3651 |
| Full Name | Sunnyside Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 617 Scoon Rd, Sunnyside, Washington |
| Authorized Official Name and Position | Rhonda Hauff (CHIEF OPERATING OFFICER/DEPUTY CEO) |
| Authorized Official Contact | 5094544143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunnyside Medical Po Box 2605 Yakima WA 98907-2605 Ph: (509) 454-4143 | Sunnyside Medical 617 Scoon Rd Sunnyside WA 98944-1031 Ph: (509) 454-4143 |
| NPI Number | 1588934079 |
|---|---|
| Provider Enumeration Date | 12/30/2011 |
| Last Update Date | 02/02/2012 |
| Medicare PECOS PAC ID | 6709786585 |
|---|---|
| Medicare Enrollment ID | O20120613000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588934079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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