Bethel Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHARCF60402548 Issued in WA

Legal business name

BETHEL PHARMACY INC

Doing business as

Bethel Pharmacy

Practice address

17414Hwy 99
Ste 100
Lynnwood, WA 98037

Phone

(425) 741-0075

Fax

(425) 741-0083

NPI assigned

Oct 31, 2006

Last updated

Jun 6, 2016By 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

Junghoon YoonNPI 1306110473

Title

President

Phone

(425) 741-0075

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BETHEL PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Locations

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.

• Jung Hoon Yoon

  • Pharmacist
  • Lynnwood, WA
  • NPI 1306110473
  NPD Authorized official
• Joseph T Bong, PHARM.D.

  • Pharmacist
  • Lynnwood, WA
  • NPI 1528465770
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1912083981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17414HWY 99",
            "address_2": "STE 100",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "425-741-0075",
            "fax_number": "425-741-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17414HWY 99",
            "address_2": "STE 100",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "425-741-0075",
            "fax_number": "425-741-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "YOON",
        "authorized_official_first_name": "JUNGHOON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-741-0075"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF60402548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6027189",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108100",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BETHEL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Lynnwood, WA
• Providers in Lynnwood, 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 Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.