Medical Lake Owl Pharmacy

LBN: Cheney Owl Pharmacy Inc
Medical Lake Owl Pharmacy is an health care organization with primary practice located at 123 E Lake St , Medical Lake WA 99022. 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. Cheney Owl Pharmacy Inc can be contacted via phone (509) 299-5113, or through Goyke, Amanda via phone (509) 235-8441.

Contact Information

Primary practice address
123 E Lake St Medical Lake WA 99022
Phone: (509) 299-5113
Fax: (509) 299-9125
Website:
Map and Directions
Authorized official contact:
Name: Goyke, Amanda PHARMD
Phone: (509) 235-8441

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHARCF00001876 Washington

Profile Details

NPI number 1316026297
LBN Legal business name Cheney Owl Pharmacy Inc
DBA Doing business as Medical Lake Owl Pharmacy
Authorized official Goyke, Amanda PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2006
Last updated Mar 11th, 2024 - about 6 months 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 1316026297 NPPES
Other 2107931 PK
MEDICAID 6067201 PK

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