Provider Demographics
NPI:1235136169
Name:CAMP RILEY DRUG CO. INC
Entity Type:Organization
Organization Name:CAMP RILEY DRUG CO. INC
Other - Org Name:PHARM A SAVE MONROE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:EDGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:360-794-7351
Mailing Address - Street 1:17788 147TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1030
Mailing Address - Country:US
Mailing Address - Phone:360-794-7351
Mailing Address - Fax:360-794-5751
Practice Address - Street 1:17788 147TH ST SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1030
Practice Address - Country:US
Practice Address - Phone:360-794-7351
Practice Address - Fax:360-805-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1835P0018X, 1835P2201X, 208U00000X, 333600000X
WA315001080332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty
No208U00000XAllopathic & Osteopathic PhysiciansClinical PharmacologyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6160006Medicaid
WA6160006Medicaid