# PENINSULA PHARMACIES INC LONG BEACH PHARMACY ANNEX

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PENINSULA PHARMACIES INC.
- **Other names:** Peninsula Compounding
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063048197
- **Legal business name:** PENINSULA PHARMACIES INC.
- **Authorized official:** JEFFREY SHANE HARRELL PHARM D (PRESIDENT)
- **Authorized official phone:** (360) 859-8659

## Contact information

- **Practice address:** 110 OREGON AVE S, LONG BEACH, WA 98631
- **Practice address phone:** (360) 642-1250
- **Practice address fax:** (888) 308-2878
- **Mailing address:** PO BOX B, ILWACO, WA 98624-0167
- **Mailing address phone:** (360) 642-1250
- **Mailing address fax:** (888) 308-2878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/20/2020
- **Last updated:** 01/19/2026