NPIMap

Organization Active NPI

Harbor Drug Corporation

  • Community/Retail Pharmacy
  • Hoquiam, WA
National Provider Identifier
1649216037
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00002046 Issued in WA
Legal business name
HARBOR DRUG CORPORATION
Doing business as
Harbor Drug Pharmacy
Practice address
316 8TH St
Hoquiam, WA 98550-3606
Phone
(360) 532-3061
Fax
(360) 537-4487
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Jeffrey Shane Harrell
Title
Owner
Phone
(360) 642-3133

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X CF00002046 WA Primary

Addresses

Primary practice location

316 8TH St
Hoquiam, WA 98550-3606

Mailing address

316 8TH St
Hoquiam, WA 98550-3606
Phone (360) 532-3061

Other identifiers 2

IdentifierTypeStateIssuer
2106787OtherPK
6034706MedicaidWA

Other names 1

  • Harbor Drug Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190903000278 WA Part B Supplier - Pharmacy 5092044925 Practice locations: Hoquiam, WA

National Provider Directory

National Provider Directory
Tax ID family
Harbor Drug Corporation2 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

316 8th St
Hoquiam, WA 98550
Phone (360) 532-3061

Practitioners & affiliated clinicians

Practitioners 5

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": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1649216037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 8TH ST",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "985503606",
            "telephone_number": "360-532-3061",
            "fax_number": "360-537-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 8TH ST",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "985503606",
            "telephone_number": "360-532-3061",
            "fax_number": "360-537-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR DRUG CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-642-3133"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00002046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106787",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6034706",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Drug Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hoquiam, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.