NPIMap

Organization Active NPI

North Olympic Healthcare Network

  • Community/Retail Pharmacy
  • Port Angeles, WA
National Provider Identifier
1336920859
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NORTH OLYMPIC HEALTHCARE NETWORK
Practice address
1026 E 1St St
Port Angeles, WA 98362-4020
Phone
(360) 504-2648
Fax
(360) 477-4279
NPI assigned
Oct 10, 2023
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Minh Dang
Title
Pharmacist
Phone
(360) 452-7891

Specialties & licenses 1

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

Addresses

Primary practice location

1026 E 1St St
Port Angeles, WA 98362-4020

Mailing address

1026 E 1St St
Port Angeles, WA 98362-4020
Phone (360) 504-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240416003000 WA Part B Supplier - Pharmacy 3779895396 1 other NPI on this enrollment
Practice locations: Port Angeles, WA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
North Olympic Healthcare Network6 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.

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Olympic Healthcare NetworkPort Angeles, WA, CCN 941039 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Mortgage Interest (100%)
5% Or Greater Security Interest (100%)		 Mar 14, 2018
Mar 14, 2018
Mar 14, 2018
North Olympic Healthcare NetworkPort Angeles, WA, CCN 501018 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Mortgage Interest (100%)
5% Or Greater Security Interest (100%)		 Dec 3, 2022
Dec 3, 2022
Dec 3, 2022
North Olympic Healthcare NetworkPort Angeles, WA, CCN 501083 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2026

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1336920859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624020",
            "telephone_number": "360-504-2648",
            "fax_number": "360-477-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624020",
            "telephone_number": "360-504-2648",
            "fax_number": "360-477-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH OLYMPIC HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "360-452-7891"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.