Clarkston Heights Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CLARKSTON HEIGHTS PHARMACY

Practice address

2119 5TH Ave
Clarkston, WA 99403-1406

Phone

(509) 758-3376

Fax

(509) 758-3377

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Pam Hays

Title

Ceo

Phone

(208) 882-5536

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245300797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 5TH AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031406",
            "telephone_number": "509-758-3376",
            "fax_number": "509-758-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 5TH AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031406",
            "telephone_number": "509-758-3376",
            "fax_number": "509-758-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON HEIGHTS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYS",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-882-5536",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6096606",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Matthew S. Clegg, D.D.S., M.S.

• Community/Retail Pharmacy in Clarkston, WA
• Providers in Clarkston, 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 Aug 22, 2020; 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.