Mipa Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF60129305 Issued in WA

Legal business name

MIPA CORP

Practice address

4629 168TH St SW Ste a
Lynnwood, WA 98037-8640

Phone

(425) 743-2211

Fax

(425) 743-2002

NPI assigned

Aug 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Annabelle Lee, RPH

Title

Owner, Phcy MGR, Pic

Phone

(425) 743-2211

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Pharmacy Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1093961146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 168TH ST SW STE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980378640",
            "telephone_number": "425-743-2211",
            "fax_number": "425-743-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 168TH ST SW STE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980378640",
            "telephone_number": "425-743-2211",
            "fax_number": "425-743-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIPA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ANNABELLE",
        "authorized_official_title_or_position": "OWNER, PHCY MGR, PIC",
        "authorized_official_telephone_number": "425-743-2211",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF60129305",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2117385",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6031983",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.