James Douglas Bannister, RPH
Individual provider Active NPI Pharmacist · Ocean Park, WA
NPI 1992830137 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992830137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH019130 (WA)
- Practice address
- 1501 Bay Ave
Ocean Park, WA 98640 - Phone
- (360) 665-6137
- Fax
- (360) 665-6264
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH019130 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sagen'S Pharmacy Inc | Pharmacist | Past | Accepting new patients |
| Sagen'S Pharmacy Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH019130 | WA | Yes |
Addresses
Primary practice location
1501 Bay Ave
Ocean Park, WA 98640
Mailing address
3307 224TH LN
Long Beach, WA 98631-7302
Phone (360) 665-2457
Other providers in Ocean Park, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.