SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION; NPI #1225033814

Contact Information

SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION

1016 TACOMA AVE
SUNNYSIDE, WA 98944

Phone: 509-837-1500
Fax: 509-837-1533
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Critical Access	282NC0060X	A0[7]	Critical Access Hospital
Medicare Defined Swing Bed Unit	275N00000X	A0[7]	Hospital-Swing Bed Approved
Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION

NPI Number 1225033814

LBN Legal business name SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION

Authorized official MATHEW MATHIESEN - (CFO)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/20/2005

Last updated 10/10/2024 - More than a year ago

Identifiers

WA	License #	600 581 630
WA	Medicaid	3300076
WA	Other	10250	LABOR & INDUSTRIES
WA	Other	147	PREMERA BLUE CROSS
WA	Other	SU9354	REGENCE BLUE SHIELD

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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