Organization
NOOKSACK VALLEY DRUG STORE LLC
Active
Other names
Valley Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEAGAN KAMMENGA (OWNER)
(360) 966-3481
Entity
Organization
Contact information
Practice address
208 E MAIN ST, EVERSON, WA 98247-0307
(360) 966-3481
(360) 966-3083
Mailing address
PO BOX 307, 208 E MAIN ST, EVERSON, WA 98247-0307
(360) 966-3481
(360) 966-3083
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6020663
—
WA
Enumeration date
02/07/2007
Last updated
02/10/2023
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