NPIMap

Organization Active NPI

Franciscan Compounding Pharmacy St Clare

  • Community/Retail Pharmacy
  • Lakewood, WA
National Provider Identifier
1316365299
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR.CF.60165416 Issued in WA
Legal business name
FRANCISCAN COMPOUNDING PHARMACY ST CLARE
Practice address
11315 Bridgeport Way SW Ste A1087
Lakewood, WA 98499-3004
Phone
(253) 985-6290
Fax
(253) 985-6295
NPI assigned
Mar 28, 2014
Last updated
Mar 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCISCAN HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Teresa Harberg, PHARMD
Title
Regional Pharmacy Manager
Phone
(253) 426-6209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHAR.CF.60165416 WA Primary

Addresses

Primary practice location

11315 Bridgeport Way SW Ste A1087
Lakewood, WA 98499-3004

Mailing address

11315 Bridgeport Way SW Ste A1087
Lakewood, WA 98499-3004
Phone (253) 985-6290

Other identifiers 1

IdentifierTypeStateIssuer
4924432OtherWANCDPD

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Hospital Lab24 organizations share this tax ID, including this one
Part of
St Joseph Hospital Lab

Other organizations with this tax ID 23

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

View all 23

Locations

11315 Bridgeport Way SW
Ste A1087
Lakewood, WA 98499
Phone (253) 985-6290

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1316365299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 BRIDGEPORT WAY SW STE A1087",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993004",
            "telephone_number": "253-985-6290",
            "fax_number": "253-985-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 BRIDGEPORT WAY SW STE A1087",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993004",
            "telephone_number": "253-985-6290",
            "fax_number": "253-985-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN COMPOUNDING PHARMACY ST CLARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN HEALTH SYSTEM",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "HARBERG",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "REGIONAL PHARMACY MANAGER",
        "authorized_official_telephone_number": "253-426-6209",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60165416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCDPD",
            "identifier": "4924432",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.