Provider Demographics
NPI:1275592651
Name:HI SCHOOL PHARMACY INC
Entity Type:Organization
Organization Name:HI SCHOOL PHARMACY INC
Other - Org Name:HI-SCHOOL PHARMACY #2100
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-693-5879
Mailing Address - Street 1:916 W EVERGREEN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3035
Mailing Address - Country:US
Mailing Address - Phone:360-213-2236
Mailing Address - Fax:360-213-2238
Practice Address - Street 1:1365 LEWIS RIVER RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9692
Practice Address - Country:US
Practice Address - Phone:360-225-9475
Practice Address - Fax:360-225-8568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF00001870333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4913580OtherNCPDP
WA6066401Medicaid
4913580OtherNCPDP