# NOOKSACK VALLEY DRUG STORE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Valley Drug
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184764458
- **Authorized official:** MRS. MEAGAN KAMMENGA (OWNER)
- **Authorized official phone:** (360) 966-3481

## Contact information

- **Practice address:** 208 E MAIN ST, EVERSON, WA 98247-0307
- **Practice address phone:** (360) 966-3481
- **Practice address fax:** (360) 966-3083
- **Mailing address:** PO BOX 307, 208 E MAIN ST, EVERSON, WA 98247-0307
- **Mailing address phone:** (360) 966-3481
- **Mailing address fax:** (360) 966-3083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | — | NULL | Yes |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | — | — | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 02/10/2023