NPIMap

Organization Active NPI

14TH Avenue Pharmacy Inc

Doing business as 14TH Avenue Community First Pharmacy

  • Community/Retail Pharmacy
  • Pasco, WA
National Provider Identifier
1710091608
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00058660 Issued in WA
Legal business name
14TH AVENUE PHARMACY INC
Doing business as
14TH Avenue Community First Pharmacy
Practice address
1200 N 14TH Ave
Ste 100
Pasco, WA 99301-4182
Phone
(509) 547-8360
Fax
(509) 547-7571
NPI assigned
Aug 18, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Scott Louderback, PHARMD
Title
President
Phone
(402) 489-1135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00058660 WA Primary

Addresses

Primary practice location

1200 N 14TH Ave
Ste 100
Pasco, WA 99301-4182

Mailing address

8055 O St Ste 201
Loudaback Pharmacies
Lincoln, NE 68510
Phone (402) 489-1135

Other identifiers 1

IdentifierTypeStateIssuer
4931932OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • 14TH AVENUE COMMUNITY FIRST PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
14TH Avenue Community First Pharmacy2 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

8055 O St
Ste 201
Lincoln, NE 68510

1200 N 14th Ave
Ste 100
Pasco, WA 99301
Phone (509) 547-1220

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1710091608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8055 O ST STE 201",
            "address_2": "LOUDABACK PHARMACIES",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68510",
            "telephone_number": "402-489-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N 14TH AVE",
            "address_2": "STE 100",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993014182",
            "telephone_number": "509-547-8360",
            "fax_number": "509-547-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "14TH AVENUE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LOUDERBACK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-489-1135",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00058660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4931932",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "14TH AVENUE COMMUNITY FIRST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.