NPIMap

Organization Active NPI

Southwest Washington Med Ctr Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Vancouver, WA
National Provider Identifier
1275744294
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00005072 Issued in WA
Legal business name
SOUTHWEST WASHINGTON MED CTR OUTPATIENT PHARMACY
Practice address
420 NE Mother Joseph Place
Vancouver, WA 98664
Phone
(360) 514-2349
Fax
(360) 514-1775
NPI assigned
May 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rebecca M Caswell, PHARMACIST
Title
Outpatient Pharmacy Manager
Phone
(360) 514-2349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00005072 WA Primary

Addresses

Primary practice location

420 NE Mother Joseph Place
Vancouver, WA 98664

Mailing address

PO Box 1600
Vancouver, WA 98668-1600
Phone (360) 514-2349

Other identifiers 1

IdentifierTypeStateIssuer
6005391MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Peacehealth6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275744294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1600",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681600",
            "telephone_number": "360-514-2349",
            "fax_number": "360-514-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE MOTHER JOSEPH PLACE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98664",
            "telephone_number": "360-514-2349",
            "fax_number": "360-514-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST WASHINGTON MED CTR OUTPATIENT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASWELL",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OUTPATIENT PHARMACY MANAGER",
        "authorized_official_telephone_number": "360-514-2349",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00005072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005391",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • 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.