SOUTH CORRECTIONAL ENTITY; NPI #1851198212

Contact Information

SOUTH CORRECTIONAL ENTITY

20817 17TH AVE S
DES MOINES, WA 98198-7665

Phone: 206-257-6200
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prison Health	261QP2400X

Indicates primary specialty

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NPI Profile & details for SOUTH CORRECTIONAL ENTITY

NPI Number	`1851198212`
LBN Legal business name	SOUTH CORRECTIONAL ENTITY
Authorized official	DEVON SCHRUM - (EXECUTIVE DIRECTOR)
Entity	Organization
Organization subpart ¹	No
Enumeration date	02/25/2025
Last updated	02/25/2025 - More than a year ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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