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Contact Information

CHENEY OWL PHARMACY INC
123 E LAKE ST
MEDICAL LAKE, WA99022
 Phone: 509-299-5113
 Fax: 509-299-9125
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CHENEY OWL PHARMACY INC

NPI # 1316026297
LBN Legal business name CHENEY OWL PHARMACY INC
Authorized official AMANDA GOYKE - (OWNER/ PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/03/2006
Last updated 03/11/2024 - About 2 years ago
Identifiers
WA License # PHARCF00001876
WA Medicaid 6067201
Other 2107931 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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