POULSBO COMPOUNDING PHARMACY LLC (NPI# 1962779348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962779348 |
Entity Type | Organization |
Organization Name | POULSBO COMPOUNDING PHARMACY LLC |
Other Organization Name | POULSBO COMPOUNDING PHARMACY |
Practice Address |
325 Ne Hostmark Street Poulsbo WA 98370 |
Mailing Address |
Po Box 2850 Poulsbo WA 98370-2850 |
Practice Telephone | 3607792737 |
Mailing Telephone | 3607792737 |
Enumeration Date | 2011-11-29 |
Last Update Date | 2012-04-12 |
Authorized Official Name | MR. BRANDON KENNETH KNOTT (OWNER) |
Authorized Official Telephone | 3607792737 |
Authorized Official Credential | PHARMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHAR.CF.60264395 | WA | Suppliers |
Other Name | Type Code |
---|---|
Poulsbo Compounding Pharmacy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114237633 | Poulsbo Compounding Pharmacy LLC | Pharmacy | 325 Ne Hostmark St, Poulsbo, WA 98370-6668 | 2010-10-18 |
Street Address |
325 NE HOSTMARK STREET |
City | POULSBO |
State | WA |
Zip Code | 98370 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790324010 | Francie Corinn Edens | Massage Therapist | 225 Nw Lindvig Way Suite# 6, Poulsbo, WA 98370 | 2020-01-03 |
1972155679 | Marcela Serocki | Massage Therapist | 18657 Wa-305, Suite 4, Poulsbo, WA 98370 | 2019-07-12 |
1508425943 | Ryan Brinton | Physical Therapist | Kitsap Physical Therapy and Sports Clinics, 19319 7th Ave Ne Ste 108, Poulsbo, WA 98370 | 2019-06-10 |
1598220816 | Naomi Whitney Orong | Massage Therapist | 19068 Nw Jenson Way, Suite 4b, Poulsbo, WA 98370 | 2019-02-01 |
1043774953 | Maryanne Phillips Bellman | Physical Therapist | 442 Viewmont Ave, Poulsbo, WA 98370 | 2019-01-24 |
1285102293 | Andrea Sander | Registered Nurse | 19883 12th Ave Ne, Poulsbo, WA 98370 | 2018-11-07 |
1376038281 | Sharon Renay Christor | Nurse Practitioner | 19160 Front St. Ne, Poulsbo, WA 98370 | 2018-06-25 |
1700304334 | Samantha Przybylek Gavinski | Nurse Practitioner | 19500 10th Ave Ne Suite 100, Poulsbo, WA 98370 | 2017-09-04 |
1285164327 | Johanna Taylor | Behavior Technician | 21786 Windmill Loop Nw, Poulsbo, WA 98370 | 2017-06-12 |
1568990554 | Eva Geurtsen | Physical Therapy Assistant | 19160 Front St, Poulsbo, WA 98370 | 2017-06-02 |
Find all providers in zip 98370 |
Taxonomy Code | 3336C0004X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Compounding Pharmacy |
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114237633 | Poulsbo Compounding Pharmacy LLC | Pharmacy | 325 Ne Hostmark St, Poulsbo, WA 98370-6668 | 2010-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417581943 | Jike LLC | Pharmacy | 8614 E Mill Plain Blvd Ste 110, Vancouver, WA 98664-2058 | 2020-02-24 |
1518444025 | Columbia Pharmacy | Pharmacy | 2700 Ne Andresen Rd Ste E3, Vancouver, WA 98661 | 2018-07-26 |
1730500067 | Kelley-ross and Assoc, Inc. | Pharmacy | 805 Madison St # 702, Seattle, WA 98104-1172 | 2014-01-06 |
1750601472 | Sound Apothecaries | Pharmacy | 1851 State Ave Ne Ste 105, Olympia, WA 98506-4601 | 2010-06-03 |
1699094417 | Darvic Assoc. Inc. | Pharmacy | 1907 Harrison Ave Nw, Olympia, WA 98502-5118 | 2010-05-18 |
1093961146 | Mipa Corp | Pharmacy | 4629 168th St Sw Ste A, Lynnwood, WA 98037-8640 | 2008-08-08 |
1578760260 | Pharmaca Integrative Pharmacy, Inc. | Pharmacy | 1815 N. 45th Street, Suite 110, Seattle, WA 98103 | 2007-06-27 |
1528199619 | Don's Pharmacy Inc. | Pharmacy | 1151 Water St, Port Townsend, WA 98368-6707 | 2007-03-08 |
1538216619 | Schwab's Compounding Pharmacy, Inc | Pharmacy | 108 B Railroad Ave., Kittitas, WA 98934 | 2007-01-04 |
1629137096 | Kelley-ross & Assoc Inc | Pharmacy | 910 Lenora St, Ste 152, Seattle, WA 98121-2754 | 2006-12-08 |
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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.