CLINIC AT ROYAL CITY; NPI #1962586503

Contact Information

CLINIC AT ROYAL CITY

101 CAMELIA ST NW
ROYAL CITY, WA 99357

Phone: 509-346-1447
Fax: 509-346-1481
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Non-Pharmacy Dispensing Site	332900000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for CLINIC AT ROYAL CITY

NPI Number 1962586503

LBN Legal business name CLINIC AT ROYAL CITY

Authorized official DIRENDIA SHACKELFORD - (MANAGED CARE SPECIALIST)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/24/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

WA	License #	MD00010548
WA	Medicaid	8213605
	Other	4928137	OTHER ID NUMBER-COMMERCIAL NUMBER

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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CLINIC AT ROYAL CITY

Contact Information

Specialty

Non-Pharmacy Dispensing Site

NPI Profile & details for CLINIC AT ROYAL CITY

Reviews for CLINIC AT ROYAL CITY