SUNCREST PHARMACY GROUP, LLC (NPI# 1669033288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669033288 |
| Entity Type | Organization |
| Organization Name | SUNCREST PHARMACY GROUP, LLC |
| Other Organization Name | SUNCREST PHARMACY |
| Practice Address |
5919f Highway 291 Nine Mile Falls WA 99026 |
| Mailing Address |
Po Box B Ilwaco WA 98624-0167 |
| Practice Telephone | 5094132030 |
| Practice Fax Number | 5094132091 |
| Mailing Telephone | 3606423133 |
| Mailing Fax Number | 3606425133 |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-11-27 |
| Authorized Official Name | ERIK NELSON (PRESIDENT) |
| Authorized Official Telephone | 5094559345 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2142653 | 05 |
| Other Name | Type Code |
|---|---|
| Suncrest Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SUNCREST PHARMACY GROUP, LLC | 1001 W Melinda Ln, Spokane, WA 99203-1364 |
| Street Address |
5919F HIGHWAY 291 |
| City | NINE MILE FALLS |
| State | WA |
| Zip Code | 99026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003332172 | Linda Diane Odell | Registered Nurse | 15010 W Four Mound Rd, Nine Mile Falls, WA 99026 | 2017-08-20 |
| 1578679767 | Greater Spokane Therapies | Physical Therapist | W 13011 Shore Road, Nine Mile Falls, WA 99026 | 2006-08-22 |
| 1669601886 | Kevin Ted Nelson | Dentist | 5952 Blackstone Way Ste 100, Nine Mile Falls, WA 99026-4900 | 2009-07-09 |
| 1285604892 | June S Goldman | Family Medicine | 5952 Blackstone Way, Lake Spokane Community Health Center, Nine Mile Falls, WA 99026-4900 | 2006-01-25 |
| 1417426511 | New Health Programs Association | Pharmacy | 5952 Blackstone Way, Nine Mile Falls, WA 99026-4900 | 2018-11-19 |
| 1356816383 | Hyojin Meadows | Nurse Practitioner | 5952 Blackstone Way, Nine Mile Falls, WA 99026-4900 | 2018-10-05 |
| 1528410545 | Kylie Mccullough | Pharmacist | 5952 Blackstone Way, Nine Mile Falls, WA 99026-4900 | 2016-07-02 |
| 1275887705 | Matthew Peter Dinsmore | Nurse Practitioner | 5952 Blackstone Way, Nine Mile Falls, WA 99026-4900 | 2012-11-06 |
| 1235455932 | New Health Programs Association | Clinic/Center | 5952 Blackstone Way Ste 100, Nine Mile Falls, WA 99026-4900 | 2010-04-20 |
| 1831214329 | New Health Programs Association | Clinic/Center | 5952 Blackstone Way, Nine Mile Falls, WA 99026-4900 | 2007-03-21 |
| Find all providers in zip 99026 | ||||
| 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 |
|---|---|---|---|---|
| 1407168461 | Valley Drug Co | Pharmacy | 5919 Highway 291 Ste 5, Nine Mile Falls, WA 99026-9525 | 2010-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1871105999 | Whidbey Island Public Hospital District | Pharmacy | 7 Ne Birch St, Coupeville, WA 98239-3132 | 2020-08-19 |
| 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 | ||||
| City | NINE MILE FALLS |
| Zip Code | 99026 |
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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.