Healthcare Provider Details

I. General information

NPI: 1255950432
Provider Name (Legal Business Name): CAMMACKS PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 E 2ND ST STE A
PORT ANGELES WA
98362-3119
US

IV. Provider business mailing address

424 E 2ND ST STE A
PORT ANGELES WA
98362-3119
US

V. Phone/Fax

Practice location:
  • Phone: 360-504-3961
  • Fax: 360-452-4288
Mailing address:
  • Phone: 360-504-3961
  • Fax: 360-452-4288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH G CAMMACK
Title or Position: OWNER
Credential: RPH
Phone: 360-452-4200