Des Moines Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00001306 Issued in WA

Legal business name

DES MOINES DRUG STORE INC

Practice address

627 So 227TH St
Des Moines, WA 98198-6827

Phone

(206) 878-2345

Fax

(206) 878-6839

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Jeffery Lee Malmo, RPH

Title

Pharmacist Owner

Phone

(206) 878-2345

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1700954781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 SO 227TH ST",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986827",
            "telephone_number": "206-878-2345",
            "fax_number": "206-878-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 SO 227TH ST",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986827",
            "telephone_number": "206-878-2345",
            "fax_number": "206-878-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES MOINES DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "MALMO",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "206-878-2345",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00001306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4903286",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6021703",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Dawson, COTA/L
• Irish Pediangco Dela Paz, PT
• Lois Marie Dennett, M.A.
• Kathrin Dentel, A.R.N.P
• Iolanda Deruiter, CDP
• Des Moines Vision Center Inc PS
• Ravi Paresh Desai
• Deborah L Devries, MA, LMHCA
• Milena Katarzyna Dickens
• Mumin Daud Dimbil, MD

• Community/Retail Pharmacy in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.