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SQUAXIN ISLAND TRIBE NPI 1548378318


NPI Information

NPI: 1548378318
Provider Name: SQUAXIN ISLAND TRIBE

Doing Business As: KAMILCHE PHARMACY

Classification: Pharmacist - 183500000X
Entity Type: Organization

CLIA Number: 50D0722390

Address:
90 SE KLAH CHE MIN DRIVE
SHELTON, WA
ZIP 98584
Phone: (360) 427-9006
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SQUAXIN ISLAND TRIBE is a pharmacist in Shelton, WA. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. SQUAXIN ISLAND TRIBE NPI is 1548378318. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Kamilche Pharmacy.

The provider's business location address is:

90 SE KLAH CHE MIN DRIVE
SHELTON, WA
ZIP 98584
Phone: (360) 427-9006
Fax: (360) 427-1951

The provider's authorized official is Edward J Fox .
The authorized official title is Hhs Director and has the following contact phone number (360) 427-9006.

The CLIA number assigned to this NPI record is 50D0722390 - other - tribal health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 7/25/2008.


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
1183500000XPharmacistYes

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
160Z6819MEDICARE ID-TYPE UNSPECIFIEDWASHINGTON
24929709OTHERNABP NCPBP

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: 5/5/2024

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