Lincoln County Healthmart Pharm

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00003505 Issued in WA

Legal business name

LINCOLN COUNTY HEALTHMART PHARM

Practice address

621 Morgan St
Davenport, WA 99122-5015

Phone

(509) 725-3310

Fax

(509) 725-3320

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Tom Paul, PHARMNPI 1811984990

Title

Owner

Phone

(509) 725-3310

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• LINCOLN COUNTY HEALTHMART PHARM Other name

Practitioners 1

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

• Tom R Paul, R.PH

  • Pharmacist
  • Davenport, WA
  • NPI 1811984990
  NPD (past) Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1508940248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991220458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MORGAN ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991225015",
            "telephone_number": "509-725-3310",
            "fax_number": "509-725-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY HEALTHMART PHARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-725-3310",
        "authorized_official_credential": "PHARM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00003505",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106601",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6045306",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINCOLN COUNTY HEALTHMART PHARM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Ann Larmer, RN
• Angela G Larson
• Lavender Luxe Massage
• Lincoln County
• Lincoln County Alcohol Drug Center
• Lincoln County Hospital District #3
• Lincoln County Hospital District #3 / North Basin Medical Clinics
• Lincoln County Hospital District #3 / North Basin Medical Clinics
• Lincoln County Hospital District 3
• Lincoln County Hospital District 3

• Community/Retail Pharmacy in Davenport, WA
• Providers in Davenport, 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 Jan 18, 2017; 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.