Organization
NOOKSACK VALLEY DRUG STORE LLC
Active
Other names
Valley Drug
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A MITCHELL RPH (OWNER/MEMBER)
(360) 303-5451
Entity
Organization
Contact information
Practice address
208 E MAIN ST, EVERSON, WA 98247-9126
(360) 966-3481
(360) 966-3083
Mailing address
PO BOX 307, EVERSON, WA 98247-0307
(360) 966-3481
(360) 966-3083
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6026003
—
WA
Enumeration date
04/08/2021
Last updated
06/26/2021
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