Mill Creek Pharmacy Inc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

PHARCF00003562 Issued in WA

Legal business name

MILL CREEK PHARMACY INC

Doing business as

Mill Creek Pharmacy

Practice address

1025 153Rd St SE Ste 104
Mill Creek, WA 98012-4051

Phone

(425) 481-7575

Fax

(425) 338-0167

NPI assigned

Aug 31, 2006

Last updated

May 6, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Somers, RPH

Title

President

Phone

(425) 481-7575

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MILL CREEK PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1699887505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE STE 104",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-481-7575",
            "fax_number": "425-338-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE STE 104",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-481-7575",
            "fax_number": "425-338-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "SOMERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-481-7575",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "PHARCF00003562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4916269",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6145601",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILL CREEK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mill Creek Family Practice PLLC
• Mill Creek Family Services, PLLC
• Mill Creek Foot & Ankle Clinic P.C.
• Mill Creek General Dentistry
• Mill Creek Implants & Periodontics
• Mill Creek Physical Therapy & Sports Rehab, Inc. P.S.
• Mill Creek Wellness Center
• Mill Creek Wellness Center, PS (Mill Creek Wellness Center)
• Mill Creek Women's Healthcare PLLC (Mill Creek Ob/Gyn)
• Mill Creek Women's Healthcare, PLLC

• Clinic Pharmacy in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Clinic Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.