NPIMap

Organization Active NPI

Eastmont Pharmacy Inc

Doing business as Eastmont Pharmacy

  • Community/Retail Pharmacy
  • E Wenatchee, WA
National Provider Identifier
1104831726
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00004184 Issued in WA
Legal business name
EASTMONT PHARMACY INC
Doing business as
Eastmont Pharmacy
Practice address
630 Valley Mall Pkwy
E Wenatchee, WA 98802-4838
Phone
(509) 884-7254
Fax
(509) 884-4698
NPI assigned
Jul 30, 2006
Last updated
Nov 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Mike Holliday
Title
Coowner
Phone
(509) 884-7254

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X CF00004184 WA Primary

Addresses

Primary practice location

630 Valley Mall Pkwy
E Wenatchee, WA 98802-4838

Mailing address

630 Valley Mall Pkwy
E Wenatchee, WA 98802-4838
Phone (509) 884-7254

Other identifiers 1

IdentifierTypeStateIssuer
4903298OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • EASTMONT PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastmont Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

630 Valley Mall Pkwy
East Wenatchee, WA 98802
Phone (509) 884-7254

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1104831726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 VALLEY MALL PKWY",
            "city": "E WENATCHEE",
            "state": "WA",
            "postal_code": "988024838",
            "telephone_number": "509-884-7254",
            "fax_number": "509-884-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 VALLEY MALL PKWY",
            "city": "E WENATCHEE",
            "state": "WA",
            "postal_code": "988024838",
            "telephone_number": "509-884-7254",
            "fax_number": "509-884-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTMONT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "509-884-7254"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00004184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4903298",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTMONT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in E Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.