Healthcare Provider Details

I. General information

NPI: 1740026889
Provider Name (Legal Business Name): PUBLIC HOSPITAL DIST NO 1 SKAGIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 05/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 EAST KINCAID STREET ATTENTION PHARMACY
MOUNT VERNON WA
98274-4127
US

IV. Provider business mailing address

1400 E KINCAID ST ATTENTION PHARMACY
MOUNT VERNON WA
98274-4127
US

V. Phone/Fax

Practice location:
  • Phone: 360-718-9782
  • Fax: 360-848-4520
Mailing address:
  • Phone: 360-718-9782
  • Fax: 360-848-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TAMARA L CESENA
Title or Position: CFO
Credential:
Phone: 360-445-8512