NPIMap

Organization Active NPI

Highway 20 Hometown Pharmacy LLC

  • Pharmacy
  • Sedro Woolley, WA
National Provider Identifier
1285012898
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHAR.CF.60552688 Issued in WA
Legal business name
HIGHWAY 20 HOMETOWN PHARMACY LLC
Doing business as
HomeTown Pharmacy
Practice address
640 State Route 20 Unit a
Sedro Woolley, WA 98284-4315
Phone
(605) 031-6763
Fax
(360) 503-1677
NPI assigned
May 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Authorized official

Name
Kathleen Maloney
Title
Director of Operations
Phone
(360) 503-1676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHAR.CF.60552688 WA Primary

Addresses

Primary practice location

640 State Route 20 Unit a
Sedro Woolley, WA 98284-4315

Mailing address

640 State Route 20 Unit a
Sedro Woolley, WA 98284-4315
Phone (360) 503-1676

Other identifiers 1

IdentifierTypeStateIssuer
2155051OtherPK

Other names 1

  • HomeTown Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

640 State Route 20
Unit A
Sedro Woolley, WA 98284
Phone (360) 503-1676

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1285012898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 STATE ROUTE 20 UNIT A",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982844315",
            "telephone_number": "360-503-1676",
            "fax_number": "360-503-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 STATE ROUTE 20 UNIT A",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982844315",
            "telephone_number": "605-031-6763",
            "fax_number": "360-503-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHWAY 20 HOMETOWN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "360-503-1676"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60552688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155051",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HomeTown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HomeTown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedro Woolley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.