NPIMap

Organization Active NPI

Public Hospital District 1 of King County

Doing business as Prescription Pad Pharmacy North

  • Community/Retail Pharmacy
  • Renton, WA
National Provider Identifier
1104969518
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR.CF.60213412 Issued in WA
Legal business name
PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY
Doing business as
Prescription Pad Pharmacy North
Practice address
3915 Talbot Rd S
Renton, WA 98055-5738
Phone
(425) 656-4050
Fax
(425) 656-5036
NPI assigned
Feb 15, 2007
Last updated
Sep 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
Ken Kenyon, PHARMD
Title
Director of Pharmacy Services/Ao
Phone
(425) 228-3440

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X PHAR.CF.60213412 WA Primary
Institutional Pharmacy 3336I0012X NU

Addresses

Primary practice location

3915 Talbot Rd S
Renton, WA 98055-5738

Mailing address

3915 Talbot Rd S
Renton, WA 98055-5738
Phone (425) 656-4050

Other identifiers 2

IdentifierTypeStateIssuer
6007975MedicaidWA
2108623OtherPK

Other names 1

  • Prescription Pad Pharmacy North Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190903001928 WA DME Supplier - Pharmacy 6901700731 Practice locations: Renton, WA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
King County Hospital Dist #13915 Talbot Rd S, Renton, WA 98055-5755(425) 690-3551 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

3915 Talbot Rd S
Renton, WA 98055
Phone (425) 630-3400

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valley Medical CenterRenton, WA, CCN 500088 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1104969518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-656-4050",
            "fax_number": "425-656-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-656-4050",
            "fax_number": "425-656-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "KENYON",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY SERVICES/AO",
        "authorized_official_telephone_number": "425-228-3440",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60213412",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007975",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108623",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prescription Pad Pharmacy North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.