Provider Demographics
NPI:1245200955
Name:K.V.H., INCORPORATED
Entity Type:Organization
Organization Name:K.V.H., INCORPORATED
Other - Org Name:DUVALL FAMILY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-788-2644
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0459
Mailing Address - Country:US
Mailing Address - Phone:425-788-2644
Mailing Address - Fax:425-788-2645
Practice Address - Street 1:15602 MAIN ST NE
Practice Address - Street 2:SUITE 210
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8524
Practice Address - Country:US
Practice Address - Phone:425-788-2644
Practice Address - Fax:425-788-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4782333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4923199OtherNCPDP NUMBER
WA6013429Medicaid
WA6013429Medicaid