Provider Demographics
NPI:1356481097
Name:AWS INC.
Entity Type:Organization
Organization Name:AWS INC.
Other - Org Name:CEDAR VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:T
Authorized Official - Last Name:HILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,
Authorized Official - Phone:360-785-4711
Mailing Address - Street 1:206 E WALNUT ST
Mailing Address - Street 2:PO BOX 536
Mailing Address - City:WINLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98596-9419
Mailing Address - Country:US
Mailing Address - Phone:360-785-4711
Mailing Address - Fax:360-785-3109
Practice Address - Street 1:206 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:WINLOCK
Practice Address - State:WA
Practice Address - Zip Code:98596-9419
Practice Address - Country:US
Practice Address - Phone:360-785-4711
Practice Address - Fax:360-785-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600298836333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6014062Medicaid