Nyberg Health Enterprises Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHARCF00058496 Issued in WA

Legal business name

NYBERG HEALTH ENTERPRISES INC

Doing business as

Snoqualmie Village Pharmacy

Practice address

7730 Center Blvd SE
Snoqualmie, WA 98065-8743

Phone

(425) 396-7474

Fax

(425) 396-7454

NPI assigned

Jul 30, 2006

Last updated

Feb 7, 2013By 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

Brockman/Shanna Nyberg, BS PHARM

Title

Pres and VP

Phone

(425) 221-0129

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SNOQUALMIE VILLAGE PHARMACY Doing business as

Tax ID family

Nyberg Health Enterprises Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Nyberg Health Enterprises Inc

  dba The Falls Pharmacy

  • Community/Retail Pharmacy
  • Snoqualmie, WA
  • NPI 1699878744
  NPD tax ID

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.

• Brittney Jean Enemark, PHARMD

  • Pharmacist
  • Seattle, WA
  • NPI 1669783742
  NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1457366007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980650797",
            "telephone_number": "425-396-7474",
            "fax_number": "425-396-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 CENTER BLVD SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980658743",
            "telephone_number": "425-396-7474",
            "fax_number": "425-396-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYBERG HEALTH ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "NYBERG",
        "authorized_official_first_name": "BROCKMAN/SHANNA",
        "authorized_official_title_or_position": "PRES AND VP",
        "authorized_official_telephone_number": "425-221-0129",
        "authorized_official_credential": "BS PHARM"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF00058496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6028922",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4931716",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SNOQUALMIE VILLAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aimee Nepomuceno, LMHCA
• New Leaf Physical Therapy and Wellness PLLC
• Hema Nirmal, MD
• Northwest Kidney Centers (NKC Snoqualmie Ridge Kidney Center)
• Colyn Nouv, DPM
• Nyberg Health Enterprises Inc (The Falls Pharmacy)
• Chinonyelum Blessing Obih, MD
• Miy Yong Obrian, PHARM.D
• Jorge Luis Orozco
• Grace Kay Owen, RN

• Community/Retail Pharmacy in Snoqualmie, WA
• Providers in Snoqualmie, 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 Feb 7, 2013; 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.