Peacehealth St John Medical Center Pharmacy
LBN: Peacehealth
Peacehealth St John Medical Center Pharmacy is an health care organization with primary practice located at 1615 Delaware St , Longview WA 98632-2367. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Peacehealth can be contacted via phone (360) 414-7451, or through Mode, Charmaine via phone (360) 414-7656.
Contact Information
Primary practice address
1615 Delaware St
Longview WA 98632-2367
Phone: (360) 414-7451
Fax: (360) 636-4921
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHAR.CF.00056869 | Washington |
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1811252687 |
|---|---|
| LBN Legal business name | Peacehealth |
| DBA Doing business as | Peacehealth St John Medical Center Pharmacy |
| Authorized official | Mode, Charmaine |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 9th, 2012 |
| Last updated | Feb 16th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811252687 | NPPES |
| Other | 2135946 | PK | |
| MEDICAID | 2022930 | PK |
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