Centralia Pharmacy

LBN: Centralia Pharmacy Group, Inc.
Centralia Pharmacy is an health care organization with primary practice located at 417 S Tower Ave , Centralia WA 98531-3917. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Centralia Pharmacy Group, Inc. can be contacted via phone (360) 736-5000, or through Harrell, Jeff via phone (360) 244-5984.

Contact Information

Primary practice address
417 S Tower Ave Centralia WA 98531-3917
Fax: (360) 736-9433
Website:
Authorized official contact:
Name: Harrell, Jeff PHARMD

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1336686039
LBN Legal business name Centralia Pharmacy Group, Inc.
DBA Doing business as Centralia Pharmacy
Authorized official Harrell, Jeff PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2017
Last updated Mar 31st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336686039 NPPES
Washington MEDICAID 2077225
Washington Other G8965128

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