Provider Demographics
NPI:1629071493
Name:PARKHILL PHARMACY, INC.
Entity Type:Organization
Organization Name:PARKHILL PHARMACY, INC.
Other - Org Name:LOPEZ ISLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-468-2616
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:LOPEZ ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98261-0190
Mailing Address - Country:US
Mailing Address - Phone:360-468-2616
Mailing Address - Fax:360-468-3825
Practice Address - Street 1:352 LOPEZ ROAD
Practice Address - Street 2:
Practice Address - City:LOPEZ ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98261-0190
Practice Address - Country:US
Practice Address - Phone:360-468-2616
Practice Address - Fax:360-468-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X, 3336C0004X, 3336L0003X
WA5102333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6014880Medicaid
WAG8912458OtherMEDICARE MASS IMMUNIZATION ROSTER BILLING
WA0330210001Medicare NSC