Provider Demographics
NPI:1962546663
Name:ROYS PHARMACY INC
Entity type:Organization
Organization Name:ROYS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-486-2149
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:TONASKET
Mailing Address - State:WA
Mailing Address - Zip Code:98855-0665
Mailing Address - Country:US
Mailing Address - Phone:509-486-2149
Mailing Address - Fax:509-486-2196
Practice Address - Street 1:318 S WHITCOMB
Practice Address - Street 2:
Practice Address - City:TONASKET
Practice Address - State:WA
Practice Address - Zip Code:98855
Practice Address - Country:US
Practice Address - Phone:509-486-2149
Practice Address - Fax:509-486-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WACF000044443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6094700Medicaid
2107557OtherPK
0368340001Medicare NSC