NPIMap

Organization Active NPI

Virginia Mason Medical Center

Doing business as Buck Pavilion Pharmacy

  • Pharmacy
  • Seattle, WA
National Provider Identifier
1174527683
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
262010301062 Issued in WA
Legal business name
VIRGINIA MASON MEDICAL CENTER
Doing business as
Buck Pavilion Pharmacy
Practice address
1100 Ninth Ave Ms: C1-PO
Seattle, WA 98101
Phone
(206) 223-6877
Fax
(206) 223-7606
NPI assigned
Jun 13, 2005
Last updated
Jul 22, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
VIRGINIA MASON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Authorized official

Name
Mr. Hung Van Truong, PHARMD
Title
Manager
Phone
(206) 341-0550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 262010301062 WA Primary

Addresses

Primary practice location

1100 Ninth Ave Ms: C1-PO
Seattle, WA 98101

Mailing address

1100 Ninth Ave Ms: C1-PO
Seattle, WA 98101
Phone (206) 223-6877

Other identifiers 2

IdentifierTypeStateIssuer
6082101MedicaidWA
4913782OtherWANCPDP

Other names 1

  • Buck Pavilion Pharmacy Doing business as

National Provider Directory

National Provider Directory
Part of
Virginia Mason Medical CNTR

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1174527683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NINTH AVE MS: C1-PO",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98101",
            "telephone_number": "206-223-6877",
            "fax_number": "206-223-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NINTH AVE MS: C1-PO",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98101",
            "telephone_number": "206-223-6877",
            "fax_number": "206-223-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA MASON MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIRGINIA MASON MEDICAL CENTER",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "HUNG",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "206-341-0550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "262010301062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6082101",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4913782",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buck Pavilion Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Buck Pavilion Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.