Healthcare Provider Details

I. General information

NPI: 1427062256
Provider Name (Legal Business Name): CAMMACKS PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 360-452-4200
  • Fax: 360-457-6557
Mailing address:
  • Phone: 360-452-4200
  • Fax: 360-457-6557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number9030552
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberCF00057963
License Number StateWA

VIII. Authorized Official

Name: MR. JOSEPH GLEN CAMMACK
Title or Position: OWNER
Credential: RPH
Phone: 360-452-4200