NPIMap

Organization Active NPI

Poulsbo Compounding Pharmacy LLC

  • Compounding Pharmacy
  • Poulsbo, WA
National Provider Identifier
1700603891
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
Legal business name
POULSBO COMPOUNDING PHARMACY LLC
Practice address
325 NE Hostmark St
Poulsbo, WA 98370-6668
Phone
(360) 697-1043
NPI assigned
Sep 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Brandon K KnottNPI 1962730317
Title
Pharmacist
Phone
(360) 994-4340

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X Primary

Addresses

Primary practice location

325 NE Hostmark St
Poulsbo, WA 98370-6668

Mailing address

PO Box 2850
Poulsbo, WA 98370-2850
Phone (360) 994-4930

Other names 1

  • Nordic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cascade Specialty Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1700603891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2850",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983702850",
            "telephone_number": "360-994-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 NE HOSTMARK ST",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706668",
            "telephone_number": "360-697-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POULSBO COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "KNOTT",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "360-994-4340"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nordic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.