Organization Active NPI

WRX Pharmacy, LLC

  • Community/Retail Pharmacy
  • Vancouver, WA
National Provider Identifier
1376198796
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WRX PHARMACY, LLC
Practice address
14313 NE 20TH Ave Ste 109
Vancouver, WA 98686-1487
Phone
(360) 787-7408
Fax
(360) 314-4727
NPI assigned
Aug 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Authorized official

Name
Bryan Horne, PHARMDNPI 1811221260
Title
Owner
Phone
(360) 787-7408

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

14313 NE 20TH Ave Ste 109
Vancouver, WA 98686-1487

Mailing address

14313 NE 20TH Ave Ste 109
Vancouver, WA 98686-1487
Phone (360) 787-7408

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210108002213 WA Part B Supplier - Mass Immunization (Roster Biller Only) 6901219070 Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

14313 NE 20th Ave
Ste 109
Vancouver, WA 98686
Phone (360) 787-7408

Practitioners & affiliated clinicians

Practitioners 2

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": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1376198796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14313 NE 20TH AVE STE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861487",
            "telephone_number": "360-787-7408",
            "fax_number": "360-314-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14313 NE 20TH AVE STE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861487",
            "telephone_number": "360-787-7408",
            "fax_number": "360-314-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRX PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-787-7408",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.