BROKEN OAK LLC (NPI# 1548887771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548887771 |
| Entity Type | Organization |
| Organization Name | BROKEN OAK LLC |
| Practice Address |
208 S Main St Omak WA 98841-9755 |
| Mailing Address |
Po Box 265 Okanogan WA 98840-0265 |
| Practice Telephone | 5097400833 |
| Mailing Telephone | 5098464910 |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-07-03 |
| Authorized Official Name | DR. APRIL M RUSSELL (OWNER) |
| Authorized Official Telephone | 5097400833 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacy Service Providers | ||
| N | 183700000X | Pharmacy Technician | Pharmacy Service Providers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| NorthStar Pharmacy | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2364 Elmway Unit 7, Okanogan, WA 988409779 | 5097400833 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | BROKEN OAK LLC | 2364 Elmway Unit 7, Okanogan, WA 98840-9779 |
| Street Address |
208 S MAIN ST |
| City | OMAK |
| State | WA |
| Zip Code | 98841-9755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073110029 | Okanogan Valley Anesthesia Center for Pain Management Pllc | Nurse Anesthetist, Certified Registered | 208 S Main St, Omak, WA 98841-9755 | 2020-10-02 |
| 1508463654 | Full Circle Health and Wellness Center Pllp | Clinic/Center | 208 S Main St, Omak, WA 98841-9755 | 2020-10-01 |
| 1023664083 | Kai Forgach | Massage Therapist | 208 S Main St, Omak, WA 98841-9755 | 2019-08-15 |
| 1639584600 | Stephen K Both Jr. | Nurse Anesthetist, Certified Registered | 208 S Main St, Omak, WA 98841-9755 | 2014-06-27 |
| 1790123123 | Cherienne Spangler | Massage Therapist | 208 S Main St, Omak, WA 98841-9755 | 2013-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093210908 | Kellie Davies | Registered Nurse | 34 Valley View Dr, Omak, WA 98841 | 2018-03-24 |
| 1356860399 | In-home Care of Central Washington | In Home Supportive Care | 130 N. Main St, Ste 2, Omak, WA 98841 | 2017-09-11 |
| 1538615158 | J.r. Craig Webster D.d.s. | Preferred Provider Organization | 204 West 1st. Street, Omak, WA 98841 | 2016-09-01 |
| 1346638855 | Katie Mae Sommers | Counselor | 1007 Koala Dr, Omak, WA 98841 | 2015-01-06 |
| 1659702157 | Omak Audiology Center, LLC | Audiologist-Hearing Aid Fitter | 506 Riverside Drive, # B, Omak, WA 98841 | 2013-12-09 |
| 1265878417 | Stephen Cavender | Counselor | 1007 Koala Dr., Omak, WA 98841 | 2013-05-15 |
| 1467793497 | Kenari Breshem | Massage Therapist | 25 Ash St, Omak, WA 98841 | 2013-03-15 |
| 1710282645 | Jodie Dawn Field | Counselor | 17 N. Ash, Omak, WA 98841 | 2011-01-25 |
| 1720391659 | Providence Health & Services | Internal Medicine | 629 Jasmine St, Omak, WA 98841 | 2010-07-20 |
| 1871826453 | Stephanie Dawn Swezey | Specialist | 670 Riverside Drive, Omak, WA 98841 | 2009-09-14 |
| Find all providers in zip 98841 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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 health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881953594 | Omak Pharmacy Inc | Pharmacy | 903 Engh Rd, Suite # A, Omak, WA 98841-9627 | 2012-05-15 |
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|---|---|---|---|---|
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| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
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| 1548883630 | Capsule Seattle LLC | Pharmacy | 2033 6th Ave Ste 120, Seattle, WA 98121-2526 | 2020-05-22 |
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1174155345 | Kaiser Foundation Health Plan of Washington | Pharmacy | 2335 172nd Street Ne, Marysville, WA 98271 | 2020-02-06 |
| 1245861996 | Salish Integrative Medicine, Inc | Pharmacy | 3700 Pacific Hwy E Ste 100b, Fife, WA 98424-1160 | 2020-01-31 |
| 1700417854 | Prosser Southgate Pharmacy Inc | Pharmacy | 207 Canyon Drive, Prosser, WA 99350-1009 | 2020-01-28 |
| 1700423639 | Venkateswara LLC | Pharmacy | 515 Minor Ave Ste 120, Seattle, WA 98104-2138 | 2019-12-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.