Nooksack Valley Drug Store LLC

Key facts

NPI: 1700466356
Entity type: Organization (NPI type 2)
Primary specialty: Long Term Care Pharmacy 3336L0003X
Legal business name: NOOKSACK VALLEY DRUG STORE LLC
Practice address: 208 E Main St
Everson, WA 98247-9126
Phone: (360) 966-3481
Fax: (360) 966-3083
NPI assigned: Apr 8, 2021
Organization subpart: No

Authorized official

Name: Scott A Mitchell, RPH
Title: Owner/Member
Phone: (360) 303-5451

Corporate family (same tax ID) 1

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

Nooksack Valley Drug Store LLC Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Everson, WA · NPI 1184764458

NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Meagan Kammenga, PHARMD Pharmacist · Everson, WA · NPI 1568651057

NPD
Norman Tang Pharmacist · Ferndale, WA · NPI 1942592696

NPD
Andrew Moore, PHARMD Pharmacist · Bellingham, WA · NPI 1124615323

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Supplier	Supplies	Medicare assignment
Valley Drug 208 East Main Street, Everson, WA 98247-0307 · (360) 966-3481	Immunosuppressive Drugs\|Nebulizer Drugs\|Oral Anticancer Drugs\|Oral Antiemetic Drugs\|Blood Glucose Monitors/Supplies (Non-Mail Order)\|Canes and/or Crutches\|Walkers\|Wheelchairs (Standard Manual)\|Urological Supplies\|Nebulizer Equipment and/or Supplies\|Diabetic Shoes and Inserts\|Diabetic Shoes/Inserts …	Does not accept assignment Participating since Apr 30, 2002

National Provider Directory

Tax ID family: Nooksack Valley Drug Store LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Long Term Care Pharmacy	3336L0003X			Yes

Addresses

Primary practice location

208 E Main St
Everson, WA 98247-9126

Mailing address

PO Box 307
Everson, WA 98247-0307
Phone (360) 966-3481

Other identifiers

Identifier	Type	State	Issuer
6026003	Medicaid	WA

Other names

Valley Drug Doing business as

Other providers in Everson, WA

All providers in Everson, WA · Long Term Care Pharmacy in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.