MATTAWA COMMUNITY MEDICAL CLINIC
NPI 1003391848
Pharmacy - Community/Retail Pharmacy in Mattawa, WA

Q: What is Grant County Public Hospital District 5's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since September 27, 2018CLIA 50D0872811 · Waiver

210 GOVERNMENT RD, MATTAWA, WA 99349(509) 932-4119(509) 932-4086 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Aug 9, 2021, Sep 27, 2018 (3 updates tracked since 2018).

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About Mattawa Community Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTAWA COMMUNITY MEDICAL CLINIC (NPI 1003391848) is a healthcare organization registered as a community/retail pharmacy in Mattawa, Washington and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Dana S Fox, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003391848

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameGRANT COUNTY PUBLIC HOSPITAL DISTRICT 5

Location Address210 GOVERNMENT RDMattawa, WA 99349-5116

Mailing AddressPo Box 1581Mattawa, WA 99349-0960 · (509) 932-4119 · Fax (509) 932-4086

Phone(509) 932-4119

Fax(509) 932-4086

Organization SubpartNo

Authorized OfficialDana S FoxCeo · (509) 932-4499

Enumeration DateSeptember 27, 2018

Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration

NPPES CertifiedAugust 9, 2021

✔ NPI 1003391848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

210 GOVERNMENT RD, Mattawa, WA 99349

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Other Names 1

Doing Business AsMattawa Community Medical Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D0872811

Grant County Hospital District #5 · Mattawa, WA

Active · expires Apr 4, 2028

CLIA Number50D0872811

Laboratory TypeCommunity Clinic

Certificate Effective DateJuly 31, 2000

Certificate Expiration DateApril 4, 2028

Laboratory DirectorJennifer Beaty

Laboratory Phone(509) 932-4499

Laboratory LocationGrant County Hospital District #5210 Government Road, Mattawa, WA 99349

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICHOLE BARTON TOMBLIN

Dentist