Village Pharmacy, Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

CF00002321 Issued in WA

Legal business name

VILLAGE PHARMACY, INC.

Practice address

815 Front St
Leavenworth, WA 98826-1376

Phone

(509) 548-7622

Fax

(509) 548-5441

NPI assigned

Jan 15, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Kathleen A Wolf, RPH

Title

President

Phone

(509) 548-7622

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Village Pharmacy HealthMart Doing business as

Locations

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1669523841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 FRONT ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261376",
            "telephone_number": "509-548-7622",
            "fax_number": "509-548-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 FRONT ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261376",
            "telephone_number": "509-548-7622",
            "fax_number": "509-548-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2014-06-13",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-548-7622",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "CF00002321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005300",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4904492",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy HealthMart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annie Elizabeth Tiedeman, LMP
• John M Tuttle, LMT
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• Upper Valley Connection
• Matthew Jay Van Dyke, L.AC.
• Vision Source of Wenatchee, PS
• Kevin A. Winters, D.C
• Howard Leland Wong, MD
• William Young III, MSPT
• Lydia Alice Zajackowski, D.C.

• Pharmacist in Leavenworth, WA
• Providers in Leavenworth, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.