MEDICARE: CORKYS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	CF00003889	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2106362	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497766992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORKYS PHARMACY INC

Provider Business Mailing Address
First Line	:	526 W 26TH PL
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99337-4942
Country	:	US
Telephone Number	:	509-586-3128
Fax Number	:	509-586-9051

Provider Business Practice Location Address
First Line	:	821 S AUBURN ST
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-5661
Country	:	US
Telephone Number	:	509-586-3128
Fax Number	:	509-586-9051

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID ALME
Credential	:
Telephone Number	:	509-586-3128

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/22/2013

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Directions to “CORKYS PHARMACY INC ” Practice Location

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