Provider Demographics
NPI:1407921216
Name:COVINGTON PHARMACY INC
Entity Type:Organization
Organization Name:COVINGTON PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAMSETH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:253-631-1200
Mailing Address - Street 1:17307 SE 272ND ST
Mailing Address - Street 2:124
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5306
Mailing Address - Country:US
Mailing Address - Phone:253-631-1200
Mailing Address - Fax:253-631-7147
Practice Address - Street 1:17307 SE 272ND ST
Practice Address - Street 2:124
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5306
Practice Address - Country:US
Practice Address - Phone:253-631-1200
Practice Address - Fax:253-631-7147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF00001258332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8800375OtherNORIDIAN
WA13071OtherLABOR & INDUSTRIES
WA6050702Medicaid
WA6050702Medicaid