Healthcare Provider Details

I. General information

NPI: 1902981806
Provider Name (Legal Business Name): OCEAN SHORES PHARMACY PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E CHANCE A LA MER NE
OCEAN SHORES WA
98569-9419
US

IV. Provider business mailing address

PO BOX 1659
OCEAN SHORES WA
98569-1659
US

V. Phone/Fax

Practice location:
  • Phone: 360-289-4647
  • Fax: 360-289-3812
Mailing address:
  • Phone: 360-289-4647
  • Fax: 360-289-3812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHANIE M MCCARTY
Title or Position: PRESIDENT
Credential:
Phone: 360-289-4647