Organization Name: | AIRWAY HEIGHTS CORRECTION CENTER |
NPI Number: | 1902197882 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LOUIS MCDERMOTT (HEALTHCARE FINANCE MANAGER) |
Mailing Address: | 11919 W. Sprague Avenue Airway Heights |
State: | WA US |
Postal Code: | 990011899 |
Phone Number: | 5092446827 |
Fax Number: | 5092446830 |
NPI Enumeration Date: | 04/26/2011 |
NPI Last Update Date: | 04/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Prison Health |
Taxonomy Definition: |