NPIMap

Organization Active NPI

Centralia Pharmacy Group Inc

Doing business as Chehalis Pharmacy LTC

  • Long Term Care Pharmacy
  • Chehalis, WA
National Provider Identifier
1750068169
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CENTRALIA PHARMACY GROUP INC
Doing business as
Chehalis Pharmacy LTC
Practice address
422 S Market Blvd
Chehalis, WA 98532-3044
Phone
(360) 262-4211
Fax
(360) 996-1001
NPI assigned
Jun 28, 2023
Last updated
Jun 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Jeffrey Shane Harrell, PHARMD
Title
President/Owner
Phone
(360) 262-4211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

422 S Market Blvd
Chehalis, WA 98532-3044

Mailing address

PO Box B
Ilwaco, WA 98624-0167
Phone (360) 262-4211

Other names 1

  • Chehalis Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Centralia Pharmacy Group Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

422 S Market Blvd
Chehalis, WA 98532
Phone (360) 262-4211

Practitioners & affiliated clinicians

Practitioners 2

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": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1750068169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX B",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986240167",
            "telephone_number": "360-262-4211",
            "fax_number": "360-996-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 S MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323044",
            "telephone_number": "360-262-4211",
            "fax_number": "360-996-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRALIA PHARMACY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "360-262-4211",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chehalis Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.