PENINSULA PHARMACIES INC LONG BEACH PHARMACY ANNEX
NPI 1063048197
Pharmacy - Compounding Pharmacy in Long Beach, WA
NPI Status: Active since March 20, 2020
Contact Information
110 OREGON AVE S
LONG BEACH, WA
ZIP 98631
Phone: (360) 642-1250
Fax: (888) 308-2878
- Organization
- Pharmacy
- Compounding Pharmacy
- Accepts Insurance
About PENINSULA PHARMACIES INC LONG BEACH PHARMACY ANNEX
This page provides the complete NPI Profile along with additional information for Peninsula Pharmacies Inc Long Beach Pharmacy Annex, a provider established in Long Beach, Washington operating as a Pharmacy, focusing in compounding pharmacy . The healthcare provider is registered in the NPI registry with number 1063048197 assigned on March 2020. The practitioner's primary taxonomy code is 3336C0004X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Jeffrey Shane Harrell Pharm D (President)
- NPI
- 1063048197
- Provider Name
- PENINSULA PHARMACIES INC LONG BEACH PHARMACY ANNEX
- Entity Type
- Organization
- Location Address
- 110 OREGON AVE S LONG BEACH, WA 98631
- Location Phone
- (360) 642-1250
- Location Fax
- (888) 308-2878
- Mailing Address
- PO BOX B ILWACO, WA 98624
- Mailing Phone
- (360) 642-1250
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-20-2020
- Last Update Date
- 03-20-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Compounding Pharmacy
- Taxonomy Code
- 3336C0004X
- Type
- Suppliers
- Taxonomy Description
- A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 3336C0003X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care - EPO
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - EPO
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
- Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Avera $1800 - PPO
- Avera $2000 - PPO
- Avera $4000 - PPO
- Avera $4500 - PPO
- Avera $6000 - PPO
- Avera $7500 HSA Eligible HDHP - PPO
- Avera $9200 - PPO
- Avera Standard $1500 - PPO
- Avera Standard $5000 - PPO
- Avera Standard $7500 - PPO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) - HMO
- Blue KC Catastrophic BlueSelect EPO - EPO
- Blue KC Choice Bronze 2 BlueSelect EPO with Spira Care - EPO
- Blue KC Choice Silver 1 BlueSelect EPO with Spira Care - EPO
- Blue KC Choice Silver BlueSelect Plus EPO with Spira Care - EPO
- Blue KC Community Silver Preferred-Care Blue EPO - EPO
- Blue KC First Bronze Preferred-Care Blue EPO - EPO
- Blue KC Saver Bronze Preferred-Care Blue EPO - EPO
- Blue KC Standard Bronze BlueSelect EPO - EPO
- Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
- Blue KC Standard Gold Preferred-Care Blue EPO - EPO
- Blue KC Standard Silver BlueSelect EPO - EPO
- Blue KC Standard Silver Preferred-Care Blue EPO - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
- CGHC Bronze Standard $7500 - Envision Network - EPO
- CGHC Catastrophic $9200 - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
- CGHC Gold $3000 - Envision Network - EPO
- CGHC Gold $3000 - Envision Network (Vision Exam) - EPO
- CGHC Gold Standard $1500 - Envision Network - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver Standard $5000 - Envision Network - EPO
- Dean Bronze $0 Copay PCP Visits - HMO
- Dean Bronze Share - HMO
- Dean Catastrophic - HMO
- Dean Expanded Bronze Standard - HMO
- Dean Focus Bronze $0 Copay PCP Visits - EPO
- Dean Focus Bronze Share - EPO
- Dean Focus Catastrophic - EPO
- Dean Focus Expanded Bronze Standard - EPO
- Dean Focus Gold HSA - EPO
- Dean Focus Gold Share - EPO
- Dean Focus Gold Standard - EPO
- Dean Focus Silver $0 Copay PCP Visits - EPO
- Dean Focus Silver Share - EPO
- Dean Focus Silver Standard - EPO
- Dean Gold HSA - HMO
- Dean Gold Share - HMO
- Dean Gold Standard - HMO
- Dean Silver $0 Copay PCP Visits - HMO
- Dean Silver Share - HMO
- Dean Silver Standard - HMO
- Atlas $1,000 Gold - PPO
- Atlas $1,500 Standard Gold - PPO
- Atlas $2,650 Plus Silver - PPO
- Atlas $3,500 HSA Silver - PPO
- Atlas $5,000 Standard Silver - PPO
- Atlas $6,500 Plus Bronze - PPO
- Atlas $7,500 Standard Bronze - PPO
- Atlas $8,200 HSA Bronze - PPO
- Atlas $9,200 Catastrophic - PPO
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Robin Select $2,800 Plus Silver - PPO
- Robin Select $3,500 HSA Silver - PPO
- Robin Select $5,000 Standard Silver - PPO
- Robin Select $6,500 Plus Bronze - PPO
- Robin Select $7,500 Standard Bronze - PPO
- Robin Select $8,200 HSA Bronze - PPO
- Robin Select $9,200 Catastrophic - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- WellFirst by Medica Bronze $0 Copay PCP Visits - EPO
- WellFirst by Medica Bronze Share - EPO
- WellFirst by Medica Catastrophic - EPO
- WellFirst by Medica Expanded Bronze Standard - EPO
- WellFirst by Medica Gold $0 Copay PCP Visits - EPO
- WellFirst by Medica Gold Copay Plus - EPO
- WellFirst by Medica Gold Standard - EPO
- WellFirst by Medica Silver $0 Copay PCP Visits - EPO
- WellFirst by Medica Silver Copay Plus - EPO
- WellFirst by Medica Silver Standard - EPO
- Moda Health Affinity Bronze 7750 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Pioneer Alaska Standard Bronze - PPO
- Moda Pioneer Alaska Standard Gold - PPO
- Moda Pioneer Alaska Standard Silver - PPO
- Moda Pioneer Bronze 6500 - PPO
- Moda Pioneer Bronze HDHP 5500 - PPO
- Moda Pioneer Gold 1500 - PPO
- Moda Pioneer Silver 4500 - PPO
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,000 - PPO
- Sanford Individual Simplicity $7,100 HSA Qualified - PPO
- Sanford Individual Simplicity $9,200 - PPO
- Sanford Individual Simplicity Standardized $1,500 - PPO
- Sanford Individual Simplicity Standardized $5,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,000 - HMO
- Sanford Individual TRUE $7,100 HSA Qualified - HMO
- Sanford Individual TRUE $9,200 - HMO
- Sanford Individual TRUE Standardized $1,500 - HMO
- Sanford Individual TRUE Standardized $5,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
- SummaCare Bronze 8000 - HMO
- SummaCare Bronze 8000 with Adult Vision Exam - HMO
- SummaCare Bronze 9200 with 3 Free PCP Visits - HMO
- SummaCare Bronze 9200 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
- SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision Exam - HMO
- SummaCare Silver 7000 with 3 Free PCP Visits - HMO
- SummaCare Standard Bronze - HMO
- SummaCare Standard Bronze with Adult Vision - HMO
- SummaCare Standard Gold - HMO
- SummaCare Standard Gold with Adult Vision - HMO
- SummaCare Standard Silver - HMO
- SummaCare Standard Silver with Adult Vision - HMO
- SummaCare Value with 3 Free PCP Visits + Adult Vision - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 6 | 3 | 0 | 4 | 8 | 1 | 9 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 12 | 3 | 0 | 4 | 16 | 1 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 2 + 3 + 0 + 4 + 1 + 6 + 1 + 1 + 8 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1063048197 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063048197, enumerated in the NPI registry as an "organization" on March 20, 2020
The provider is located at 110 Oregon Ave S Long Beach, Wa 98631 and the phone number is (360) 642-1250
This medical organization specializes in Pharmacy with taxonomy code 3336C0004X with a focus in Compounding Pharmacy
The provider might be accepting Accepts: Aetna CVS Health, Antidote Health Plan of Arizona,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on March 20, 2020. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.