Provider Demographics
NPI:1568735355
Name:SAMEK, JOSEPH E (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:SAMEK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:SAMEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS PHARMACY
Mailing Address - Street 1:13414 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0848
Mailing Address - Country:US
Mailing Address - Phone:509-924-1744
Mailing Address - Fax:509-924-9724
Practice Address - Street 1:13414 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0848
Practice Address - Country:US
Practice Address - Phone:509-924-1744
Practice Address - Fax:509-924-9724
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00017169OtherWA STATE PHARMACIST LICENSE