NPIMap

Organization Active NPI

Matrx Pharmacy, LLC

Doing business as Matrx LTC Pharmacy

  • Long Term Care Pharmacy
  • Snohomish, WA
National Provider Identifier
1700223526
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHAR.CF.60365255 Issued in WA
Legal business name
MATRX PHARMACY, LLC
Doing business as
Matrx LTC Pharmacy
Practice address
1030 Avenue D
Ste 2
Snohomish, WA 98290-2086
Phone
(360) 863-3009
Fax
(360) 217-7570
NPI assigned
Jun 3, 2013
Last updated
Jun 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Authorized official

Name
Janet KuslerNPI 1669566386
Title
Pharmacist
Phone
(360) 863-3009

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU
Long Term Care Pharmacy 3336L0003X PHAR.CF.60365255 WA Primary

Addresses

Primary practice location

1030 Avenue D
Ste 2
Snohomish, WA 98290-2086

Mailing address

1030 Avenue D
Ste 2
Snohomish, WA 98290-2086
Phone (360) 863-3009

Other identifiers 1

IdentifierTypeStateIssuer
2140751OtherPK

Other names 1

  • Matrx LTC Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130904000305 WA Part B Supplier - Pharmacy 4981847340 Practice locations: Snohomish, WA

National Provider Directory

National Provider Directory
Tax ID family
Matrx Pharmacy LLC2 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

1030 Avenue D
Ste 2
Snohomish, WA 98290
Phone (360) 863-3009

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1700223526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 AVENUE D",
            "address_2": "STE 2",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902086",
            "telephone_number": "360-863-3009",
            "fax_number": "360-217-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 AVENUE D",
            "address_2": "STE 2",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902086",
            "telephone_number": "360-863-3009",
            "fax_number": "360-217-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRX PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "KUSLER",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "360-863-3009"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60365255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140751",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrx LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snohomish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.