Provider Demographics
NPI:1922181478
Name:BATES DRUG STORES INC
Entity Type:Organization
Organization Name:BATES DRUG STORES INC
Other - Org Name:BATES PHARMACEUTICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-489-4500
Mailing Address - Street 1:3704 N NEVADA ST
Mailing Address - Street 2:STE B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2968
Mailing Address - Country:US
Mailing Address - Phone:509-489-4500
Mailing Address - Fax:509-489-4330
Practice Address - Street 1:3704 N NEVADA ST
Practice Address - Street 2:STE B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2968
Practice Address - Country:US
Practice Address - Phone:509-489-4500
Practice Address - Fax:509-489-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF000579353336L0003X
3336M0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6028583Medicaid
2108574OtherPK