CREEKSIDE PHARMACY LLC (NPI# 1003387697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003387697 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE PHARMACY LLC |
| Practice Address |
639 Morgan Street Davenport WA 99122 |
| Mailing Address |
Po Box 760 Davenport WA 99122-0760 |
| Practice Telephone | 5097250551 |
| Practice Fax Number | 5097250935 |
| Mailing Telephone | 5097250551 |
| Mailing Fax Number | 5097250935 |
| Enumeration Date | 2018-12-08 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | LANAE WIATER (OWNER) |
| Authorized Official Telephone | 5097250551 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2128366 | 05 |
| Street Address |
639 MORGAN STREET |
| City | DAVENPORT |
| State | WA |
| Zip Code | 99122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366959470 | Kandis Rose Paskell | Counselor | 547 Morgan Street, Davenport, WA 99122 | 2018-01-10 |
| 1538567839 | Alyssa Fleming | Speech-Language Pathologist | 28000 Prairie Springs Drive, Davenport, WA 99122 | 2014-12-18 |
| 1477742500 | Daniel W Pitman | Counselor | 1102 8th Street, Davenport, WA 99122 | 2007-10-15 |
| 1730201856 | Capstone Behavioral Health | Counselor | 49 Park Street, Davenport, WA 99122 | 2007-04-06 |
| 1972625762 | David Lee Turner | Dentist | 707 Logan St, Davenport, WA 99122 | 2007-04-04 |
| 1982723318 | Dawn Lorraine Wilcox | Counselor | 49 Park, Unit C, Davenport, WA 99122 | 2007-03-28 |
| 1184789703 | Michael G Van Pevenage | Physical Therapist | 506 Morgan Street, Davenport, WA 99122 | 2006-12-26 |
| 1447323811 | Davenport Vision Clinic, Inc. | Optometrist | 506 8th St, Davenport, WA 99122 | 2006-11-15 |
| 1912002791 | Davenport Pharmacy Inc | Pharmacy | 525 Morgan St, Davenport, WA 99122 | 2006-09-14 |
| 1912927518 | Stacie R. Nichols | Optometrist | 506 8th St., Davenport, WA 99122 | 2006-07-19 |
| Find all providers in zip 99122 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104127349 | Walgreen Co | Pharmacy | 40079 Highway 27, Davenport, FL 33837-7800 | 2010-11-04 |
| 1477730406 | Holiday Cvs LLC | Pharmacy | 5000 Grandview Pkwy, Davenport, FL 33837-2300 | 2008-01-22 |
| 1033207469 | Family Drug Center | Pharmacy | State Route 80, Davenport, VA 24239-0129 | 2006-10-11 |
| 1912002791 | Davenport Pharmacy Inc | Pharmacy | 525 Morgan St, Davenport, WA 99122 | 2006-09-14 |
| 1538174842 | Walgreen Co | Pharmacy | 1720 W Kimberly Rd, Davenport, IA 52806-4742 | 2006-07-29 |
| 1194769562 | Iowa Cvs Pharmacy LLC | Pharmacy | 1655 W Kimberly Rd, Davenport, IA 52806-5532 | 2006-06-16 |
| 1881172146 | Costco Wholesale Corporation | Pharmacy | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-30 |
| 1295042133 | Jya, LLC | Pharmacy | 141 Webb Dr, Suite 100, Davenport, FL 33837-3951 | 2010-09-13 |
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|---|---|---|---|---|
| 1700493533 | Doctors Pharmacy, LLC | Pharmacy | 65 Columbia Point Dr, Richland, WA 99352-4375 | 2020-09-25 |
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| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1811511454 | Kaiser Foundation Health Plan of Washington | Pharmacy | 189 Telegraph Rd, Bellingham, WA 98226-8079 | 2020-05-29 |
| 1548883630 | Capsule Seattle LLC | Pharmacy | 2033 6th Ave Ste 120, Seattle, WA 98121-2526 | 2020-05-22 |
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1174155345 | Kaiser Foundation Health Plan of Washington | Pharmacy | 2335 172nd Street Ne, Marysville, WA 98271 | 2020-02-06 |
| 1245861996 | Salish Integrative Medicine, Inc | Pharmacy | 3700 Pacific Hwy E Ste 100b, Fife, WA 98424-1160 | 2020-01-31 |
| 1700417854 | Prosser Southgate Pharmacy Inc | Pharmacy | 207 Canyon Drive, Prosser, WA 99350-1009 | 2020-01-28 |
| 1700423639 | Venkateswara LLC | Pharmacy | 515 Minor Ave Ste 120, Seattle, WA 98104-2138 | 2019-12-10 |
| Find all providers with the same taxonomy | ||||
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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.