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Contact Information

CCA OF SPOKANE, LLC
122 W 7TH AVE
STE 540
SPOKANE, WA99204
 Phone: 509-232-0567
 Fax: 509-232-0571
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physiological Laboratory, (Independent Physiological Lab)

293D00000X 47 Independent Diagnostic Testing Facility (IDTF)
Indicates primary specialty

NPI Profile & details for CCA OF SPOKANE, LLC

NPI # 1912934878
LBN Legal business name CCA OF SPOKANE, LLC
Authorized official JOHN COMBS - (DIRECTOR OF OPERATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 06/27/2006
Last updated 08/20/2009 - About 17 years ago
Identifiers
WA License # FX00057836
ID Medicaid 806709200
WA Medicaid 7120652
Other P00077314 RAILROAD MEDICARE
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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