Bonney Lake Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BONNEY LAKE PHARMACY, LLC

Doing business as

Bonney Lake Pharmacy

Practice address

19102 Sr 410 E Ste B
Bonney Lake, WA 98391-8449

Phone

(253) 447-7669

Fax

(253) 447-7841

NPI assigned

Nov 19, 2021

Last updated

Jul 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin G Lochala, PHARMD, RPHNPI 1346673969

Title

Pharmacist/Pharmacy Owner

Phone

(253) 447-7669

Specialties & licenses 2

Addresses

Other names 1

• Bonney Lake Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Lochala, PHARMD, RPH

  • Pharmacist
  • Bonney Lake, WA
  • NPI 1346673969
  NPD Authorized official

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1447917851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15817 198TH AVE E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917450",
            "telephone_number": "207-491-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19102 SR 410 E STE B",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918449",
            "telephone_number": "253-447-7669",
            "fax_number": "253-447-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNEY LAKE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "LOCHALA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHARMACIST/PHARMACY OWNER",
        "authorized_official_telephone_number": "253-447-7669",
        "authorized_official_credential": "PHARMD, RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonney Lake Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bonney Lake Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Bonney Lake, WA
• Providers in Bonney Lake, 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 Jul 29, 2022; 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.