Willapa Harbor Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF.60061411 Issued in WA

Legal business name

WILLAPA HARBOR PHARMACIES INC

Practice address

101 Willapa Ave
South Bend, WA 98586

Phone

(360) 875-5757

Fax

(360) 875-6021

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Dave Cox

Title

Owner

Phone

(360) 875-5757

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SOUTH BEND PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 2

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

• David A Cox, RPH

  • Pharmacist
  • South Bend, WA
  • NPI 1306191408
  NPD (past)
• Matthew J Cox, RPH

  • Pharmacist
  • South Bend, WA
  • NPI 1083969075
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525305600000",
    "number": "1417036997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985860395",
            "telephone_number": "360-875-5757",
            "fax_number": "360-875-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLAPA AVE",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "98586",
            "telephone_number": "360-875-5757",
            "fax_number": "360-875-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAPA HARBOR PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2018-05-03",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-875-5757"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF.60061411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2107430",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107007",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BEND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Bend School District
• Anne Elizabeth Townsend, L.D.
• Vitality Massage
• Washington Physical Therapy
• Willapa Family Medicine PS

• Community/Retail Pharmacy in South Bend, WA
• Providers in South Bend, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.