Organization · Type 2 NPI

Peacehealth

Community/Retail Pharmacy · Longview, WA

NPI number 1811252687 Active

Practice location

1615 Delaware St
Longview, WA 98632-2367

Call (360) 414-7451 Map

Fax (360) 636-4921

Mailing address

PO Box 3002
Longview, WA 98632-0302

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PHAR.CF.00056869 (WA)
Specialty Pharmacy	3336S0011X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

267 other providers at this address

Other community/retail pharmacy providers in Longview

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NPI record

NPI: 1811252687
Entity type: Organization (Type 2)
Issued: Jul 9, 2012
Last updated: Feb 16, 2022
Status: Active

Other names

<unavail>
Peacehealth ST John Medical Center Pharmacy · doing business as
Peacehealth ST John Medical Center Pharmacy · doing business as

Authorized official

Charmaine Mode
MGR Pharmacy SJM - Pharmacy
(360) 414-7656

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1811252687

Peacehealth's National Provider Identifier is 1811252687, issued on Jul 9, 2012. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Longview, WA. The record was last updated on Feb 16, 2022.