NPIMap

Organization Active NPI

Cheney Owl Pharmacy Inc

  • Community/Retail Pharmacy
  • Grand Coulee, WA
National Provider Identifier
1639689748
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHAR.CF.60747617 Issued in WA
Legal business name
CHENEY OWL PHARMACY INC
Practice address
411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone
(509) 633-6425
Fax
(509) 633-6358
NPI assigned
Oct 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Amanda Goyke, PHARMD
Title
President
Phone
(509) 999-2355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHAR.CF.60747617 WA Primary

Addresses

Primary practice location

411 Fortuyn Rd
Grand Coulee, WA 99133-8718

Mailing address

411 Fortuyn Rd
Grand Coulee, WA 99133-8718

Other identifiers 1

IdentifierTypeStateIssuer
PHAR.CF.60747617OtherWAPHARMACY LICENSE

Other names 1

  • Coulee Owl Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cheney Owl Pharmacy Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1639689748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FORTUYN RD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991338718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FORTUYN RD",
            "city": "GRAND COULEE",
            "state": "WA",
            "postal_code": "991338718",
            "telephone_number": "509-633-6425",
            "fax_number": "509-633-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENEY OWL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "GOYKE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-999-2355",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60747617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHAR.CF.60747617",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coulee Owl Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Coulee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.