PENINSULA PHARMACIES INC. (NPI# 1104423870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104423870 |
| Entity Type | Organization |
| Organization Name | PENINSULA PHARMACIES INC. |
| Practice Address |
101 1st Ave S Ilwaco WA 98624-9100 |
| Mailing Address |
Po Box B Ilwaco WA 98624-0167 |
| Practice Telephone | 3606423133 |
| Practice Fax Number | 3606425133 |
| Mailing Telephone | 3606423133 |
| Mailing Fax Number | 3606425133 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | JEFFREY SHANE HARRELL (PRESIDENT) |
| Authorized Official Telephone | 3606423133 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Ilwaco Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770665754 | Peninsula Pharmacies Inc. | Pharmacy | 1501 Bay Ave, Ocean Park, WA 98640-4203 | 2006-10-19 |
| Street Address |
101 1ST AVE S |
| City | ILWACO |
| State | WA |
| Zip Code | 98624-9100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285771774 | Susan C Freese | Pharmacist | 101 1st Ave S, Ilwaco, WA 98624-0167 | 2007-01-31 |
| 1518334523 | Public Hospital District 3 of Pacific County | Family Medicine | 101 1st Ave S, Ilwaco, WA 98624-9100 | 2015-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215240593 | Discovery Coast Emergency Physicians LLC | Emergency Medicine | 174 First Ave. North, Ilwaco, WA 98624 | 2010-07-15 |
| 1720216302 | Jeffrey J Chabot | Pharmacist | 101 Spruce, Ilwaco, WA 98624 | 2009-06-23 |
| 1700025137 | Penny Irene Neal | Specialist | 120 First Avenue, Ilwaco, WA 98624 | 2009-02-09 |
| 1487817508 | Pacific Heart Associates PC | Specialist | 174 First Ave N, Ilwaco, WA 98624 | 2008-07-09 |
| 1639396203 | Ocean Beach Chiropractic Ps | Chiropractor | 167 First Avenue, North, Ilwaco, WA 98624 | 2007-04-18 |
| 1265568133 | Tamra Kay Roloff | Midwife | 901 Lakeview Drive, Ilwaco, WA 98624 | 2007-02-26 |
| 1255416038 | Peninsula Pharmacies Inc | Pharmacy | 101 1st Ave South, Ilwaco, WA 98624 | 2006-10-27 |
| 1356423883 | Ocean Beach Physical Therapy Inc | Physical Therapist | 316 1st Ave. North, Ilwaco, WA 98624 | 2006-10-20 |
| 1295825727 | Thomas Sutherland | Pharmacist | 101 First Ave S, Ilwaco Pharmacy, Ilwaco, WA 98624 | 2006-10-13 |
| 1922198662 | Victoria Margaret Vestal | Physical Therapist | 316 1st Ave North, Ilwaco, WA 98624 | 2006-10-13 |
| Find all providers in zip 98624 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1316577869 | Ksr Health Care LLC | Pharmacy | 507 W Stevens Ave Ste Aaa, Sultan, WA 98294-9515 | 2020-01-23 |
| 1730724105 | Silver Lake Pharmacy Inc | Pharmacy | 10315 19th Ave Se Ste 104, Everett, WA 98208-4268 | 2019-11-09 |
| 1437708641 | Ets Consulting LLC | Pharmacy | 6007 244th St Sw Ste A1, Mountlake Terrace, WA 98043-5427 | 2019-09-10 |
| 1891341616 | Nwpa Inc | Pharmacy | 21509 State Route 410 E Ste 4, Bonney Lake, WA 98391-4104 | 2019-08-16 |
| 1669033288 | Suncrest Pharmacy Group, LLC | Pharmacy | 5919f Highway 291, Nine Mile Falls, WA 99026 | 2019-06-25 |
| 1750948956 | Lacey Square Pharmacy Inc | Pharmacy | 6020 Pacific Ave Se Ste C, Lacey, WA 98503-1319 | 2019-05-22 |
| 1306338868 | Manhattan Village Pharmacy Inc. | Pharmacy | 10102 E Knox Ave Ste 400, Spokane Valley, WA 99206-4146 | 2018-05-31 |
| 1528566981 | Rxltc, Pllc | Pharmacy | 969 Stevens Dr Ste 1b, Richland, WA 99352 | 2018-01-31 |
| 1891167755 | Think Different | Pharmacy | 31710 50th Ln Sw Apt V201, Federal Way, WA 98023-3747 | 2015-10-30 |
| 1104207372 | Prescription Pharmacy Pllc | Pharmacy | 800 Swift Blvd Ste 140, Richland, WA 99352-3559 | 2015-06-14 |
| 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.