Provider Demographics
NPI:1033112883
Name:COST PLUS PRESCRIPTIONS, INC.
Entity Type:Organization
Organization Name:COST PLUS PRESCRIPTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:253-572-9018
Mailing Address - Street 1:204 N I ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1926
Mailing Address - Country:US
Mailing Address - Phone:253-572-9018
Mailing Address - Fax:253-627-7685
Practice Address - Street 1:204 N I ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1926
Practice Address - Country:US
Practice Address - Phone:253-572-9018
Practice Address - Fax:253-627-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 335E00000X
WA026202CF00002490333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA14504OtherL&I
WA9040379Medicaid
WA7331093Medicaid
WA6018006Medicaid
WACO3219OtherREGENCE BLUE SHIELD
WA9045956Medicaid
WAAB09090OtherMEDICARE ROSTER BILLER #
WA7331093Medicaid