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SIXTH AVENUE MEDICAL PHARMACY INC NPI 1124039623


NPI Information

NPI: 1124039623
Provider Name: SIXTH AVENUE MEDICAL PHARMACY INC

Doing Business As: SIXTH AVENUE MEDICAL PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 50D2273935

Address:
508 W 6TH AVE
SPOKANE, WA
ZIP 99204
Phone: (509) 455-9345
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SIXTH AVENUE MEDICAL PHARMACY INC is a pharmacy in Spokane, WA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. SIXTH AVENUE MEDICAL PHARMACY INC NPI is 1124039623. The provider is registered as an organization entity type.
The provider Is Doing Business As Sixth Avenue Medical Pharmacy.

The provider's business location address is:

508 W 6TH AVE
SPOKANE, WA
ZIP 99204-770
Phone: (509) 455-9345
Fax: (509) 455-4479

The provider's authorized official is Erik Nelson .
The authorized official title is Pic and has the following contact phone number (509) 455-9345.

The CLIA number assigned to this NPI record is 50D2273935 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 6/21/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0004XPharmacyCompounding PharmacyNo
23336L0003XPharmacyLong Term Care PharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyNo
4333600000XPharmacyPHAR.CF.60411553WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16154702MEDICAIDWASHINGTON
22143800OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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