PROVIDENCE HEALTHCARE (NPI# 1952592917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952592917 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTHCARE |
| Other Organization Name | HOLY FAMILY HOSPITAL CRNA |
| Practice Address |
5633 N Lidgerwood St Spokane WA 99208-1224 |
| Mailing Address |
910 N Washington St Suite 209 Spokane WA 99201-2202 |
| Practice Telephone | 5094820111 |
| Mailing Telephone | 5092321173 |
| Mailing Fax Number | 5092321165 |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |
| Authorized Official Name | DEBBIE L WICKLUND (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 5092321177 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTHCARE DBA HOLY FAMILY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | H 139 | WA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LICENSE NUMBER | H 139 | 01 |
| WA | FACILITY ID | 000030 | 01 |
| WA | 9611674 | 05 |
| Other Name | Type Code |
|---|---|
| HOLY FAMILY HOSPITAL CRNA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770856072 | Providence Healthcare | Home Health | 8505 Nw 74th St, Suite B, Miami, FL 33166-2327 | 2012-02-16 |
| 1720279953 | Providence Healthcare | General Acute Care Hospital | 1015 E D St, Deer Park, WA 99006-5067 | 2007-08-05 |
| 1174692289 | Providence Healthcare | Assisted Living Facility | 34 E 8th Ave, Spokane, WA 99202-7210 | 2006-11-06 |
| 1194917849 | Providence Healthcare | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2007-08-16 |
| 1215128277 | Providence Healthcare | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2007-08-06 |
| 1588855548 | Providence Healthcare | General Acute Care Hospital | 500 E Webster Ave, Chewelah, WA 99109-9523 | 2007-08-06 |
| 1417148461 | Providence Healthcare | General Acute Care Hospital | 1015 E D St, Deer Park, WA 99006-5067 | 2007-08-06 |
| 1225229289 | Providence Healthcare | General Acute Care Hospital | 500 E Webster Ave, Chewelah, WA 99109-9523 | 2007-08-06 |
| 1861683823 | Providence Healthcare | General Acute Care Hospital | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2007-08-06 |
| 1497946453 | Providence Healthcare | General Acute Care Hospital | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2007-08-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Healthcare LLC | 4702 Ardley Drive, Colorado Springs, CO 80922 |
| Oklahoma Business Registrations | PROVIDENCE HEALTHCARE MANAGEMENT, LLC | 202 S Main, Po Box 1009, Gore, OK 74435 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTHCARE OF MS, LLC | 118 Levon Owens Dr, Terry, MS 39170-9696 |
| Street Address |
5633 N LIDGERWOOD ST |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881693919 | Mark J Erwin | Physician Assistant | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2005-07-20 |
| 1881247450 | John Landkammer | Pharmacist | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2019-07-22 |
| 1669913331 | Hope Tran | Pharmacist | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2017-03-15 |
| 1932571080 | Krista Arthur | Pharmacist | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2015-10-28 |
| 1700258324 | Taylor Joel Jackson | Pharmacist | 5633 N Lidgerwood St, Spokane, WA 99208 | 2015-10-22 |
| 1831509561 | Bradley Alice | Emergency Medicine | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2014-05-02 |
| 1457693558 | Joseph Francis Tkacik | Nurse Practitioner | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2013-03-27 |
| 1336445634 | Emergency Physician Services Ps Holy Emergency Center | Emergency Medicine | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2011-02-03 |
| 1447493283 | Anita Marie Tuider | Dietitian, Registered | 5633 N Lidgerwood St, Holy Family Hospital/food & Nutrition Services, Spokane, WA 99208-1224 | 2009-04-09 |
| 1235371675 | Johnny Nguyen Do | Internal Medicine | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2009-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952525644 | Maui Memorial Hospital | General Acute Care Hospital | 819 W 7th Ave, Spokane, WA 99204-2808 | 2007-04-12 |
| 1124078969 | Spokane Vamc | General Acute Care Hospital | N. 4815 Assembly, Spokane, WA 99205-6185 | 2006-05-11 |
| 1588923262 | Vamc | General Acute Care Hospital | 4815 N Assembly St, Spokane, WA 99205-6185 | 2012-05-15 |
| 1962723684 | Providence Sacred Heart Medical Center | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2010-06-16 |
| 1083866453 | Providence Health & Services - Washington | General Acute Care Hospital | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2008-10-16 |
| 1891947263 | Providence Health & Services - Wa | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2008-10-16 |
| 1225289895 | Providence Health & Services - Washington | General Acute Care Hospital | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2008-10-01 |
| 1588831622 | Providence Health Care | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2008-05-08 |
| 1396912432 | Providence Health Care | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2008-05-08 |
| 1356528269 | Multicare Health System | General Acute Care Hospital | 800 W 5th Ave, Spokane, WA 99204-2803 | 2008-01-23 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.