Cowlitz Pharmacy Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

CF00058295 Issued in WA

Legal business name

COWLITZ PHARMACY INC.

Doing business as

Olympic Drug #1158

Practice address

1244 15TH Ave
Longview, WA 98632-3023

Phone

(360) 423-3360

Fax

(360) 423-3364

NPI assigned

Mar 23, 2006

Last updated

Nov 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Winfield F Muffett III, RPH

Title

Owner

Phone

(360) 693-5879

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Olympic Drug #1158 Doing business as

Locations

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1902866155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 W EVERGREEN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603035",
            "telephone_number": "360-213-2236",
            "fax_number": "360-213-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 15TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323023",
            "telephone_number": "360-423-3360",
            "fax_number": "360-423-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWLITZ PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "MUFFETT",
        "authorized_official_first_name": "WINFIELD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-693-5879",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "CF00058295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6028435",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4904579",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympic Drug #1158",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cowlitz Indian Tribe
• Cowlitz Indian Tribe
• Cowlitz Indian Tribe
• Cowlitz Indian Tribe
• Cowlitz Indian Tribe
• Jan Marie Cox
• Stephanie Cox, RN
• Brenna Jane Coy, B.A., CAAR
• Heidi Craig
• Dawn Marie Cramer, RN

• Pharmacy in Longview, WA
• Providers in Longview, WA by specialty
• Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.