PROFESSIONAL MALL PHARMACY INC NPI 1669559530

NPI Information

  • NPI: 1669559530
  • Provider Name: PROFESSIONAL MALL PHARMACY INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: SIDS PROFESSIONAL PHARMACY
  • Address: 825 SE BISHOP BLVD
    STE 301
    PULLMAN, WA
    ZIP 99163
  • Phone: (509) 332-4608

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NPI Details

PROFESSIONAL MALL PHARMACY INC is a community/retail pharmacy pharmacy in Pullman, WA. The provider is 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 health care providers, collaborative practice, disease state management, and education classes. PROFESSIONAL MALL PHARMACY INC NPI is 1669559530. The provider is registered as an organization entity type.
The provider Is Doing Business As Sids Professional Pharmacy.

The provider's business location address is:

825 SE BISHOP BLVD
STE 301
PULLMAN, WA
ZIP 99163-517
Phone: (509) 332-4608
Fax: (509) 332-3341

The provider's authorized official is Darcy Linderman .
The authorized official title is Office Manager and has the following contact phone number (509) 332-0630.

The enumeration date for this NPI number is 10/31/2006 and was last updated on 5/5/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
33336C0004XPharmacyCompounding PharmacyNo
43336C0003XPharmacyCommunity/Retail PharmacyCF00001254WASHINGTONYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14328400MEDICAIDIDAHO
26564307MEDICAIDWASHINGTON
3G000301261MEDICARE PIN
44905836OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
50427300001MEDICARE NSC

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: 11/21/2025

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