Brown & Cole Stores LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00057120 Issued in WA

Legal business name

BROWN & COLE STORES LLC

Doing business as

Food Pavilion #775 Pharmacy

Practice address

149 Easy St
Wenatchee, WA 98801-5995

Phone

(509) 665-0269

Fax

(509) 665-0752

NPI assigned

Jan 19, 2007

Last updated

Sep 9, 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. Dave Rasmusson

Title

Pharmacy Coordinator

Phone

(360) 714-7749

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Food Pavilion #775 Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1972656098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 COMMERCIAL ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254307",
            "telephone_number": "360-714-7718",
            "fax_number": "360-714-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 EASY ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988015995",
            "telephone_number": "509-665-0269",
            "fax_number": "509-665-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN & COLE STORES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "RASMUSSON",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "PHARMACY COORDINATOR",
        "authorized_official_telephone_number": "360-714-7749",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00057120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6025555",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Food Pavilion #775 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katharine Ann Broberg, MSW
• Mark A. Broberg, M.D.
• Jennifer Lynn Brooks, SUDP
• Shelbi Brough, RPD
• Rocky C Browder, MD
• Ada Lori Brown, RN
• Chelsea Jean Van Horn Brown, PA
• Daniel William Brown, MD
• David Carl Brown
• Dennis Mark Brown

• Community/Retail Pharmacy in Wenatchee, WA
• Providers in Wenatchee, 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 Sep 9, 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.