Organization Active NPI

Parkhill Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Lopez Island, WA
National Provider Identifier
1629071493
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PARKHILL PHARMACY, INC.
Doing business as
Lopez Island Pharmacy
Practice address
352 Lopez Road
Lopez Island, WA 98261-0190
Phone
(360) 468-2616
Fax
(360) 468-3825
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Authorized official

Name
Mr. Richard C McCoy Jr., R.PH.NPI 1336142967
Title
Pharmacist
Phone
(360) 468-2616

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 5102 WA
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

352 Lopez Road
Lopez Island, WA 98261-0190

Mailing address

PO Box 190
Lopez Island, WA 98261-0190
Phone (360) 468-2616

Other identifiers 2

IdentifierTypeStateIssuer
6014880MedicaidWA
G8912458OtherWAMEDICARE MASS IMMUNIZATION ROSTER BILLING

Other names 1

  • Lopez Island Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930013517 WA DME Supplier - Pharmacy 7911024633 Practice locations: Lopez Island, WA
O20121025000278 WA Part B Supplier - Mass Immunization (Roster Biller Only) 7911024633 Practice locations: Lopez Island, WA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2250803Lopez Island Pharmacy352 Lopez Rd, Lopez Island, WA 98261Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Parkhill Pharmacy 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.

Locations

157 Village Rd
Lopez Island, WA 98261
Phone (360) 468-2616

Practitioners & affiliated clinicians

Practitioners 3

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1629071493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "LOPEZ ISLAND",
            "state": "WA",
            "postal_code": "982610190",
            "telephone_number": "360-468-2616",
            "fax_number": "360-468-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 LOPEZ ROAD",
            "city": "LOPEZ ISLAND",
            "state": "WA",
            "postal_code": "982610190",
            "telephone_number": "360-468-2616",
            "fax_number": "360-468-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKHILL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "360-468-2616",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "5102",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6014880",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MASS IMMUNIZATION ROSTER BILLING",
            "identifier": "G8912458",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lopez Island Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lopez Island Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lopez Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.