Jesse "John" Slagle arrived in Republic in 1904, having been sent by the Stewart & Holms Wholesale Drug Company, his employer at the time, with instructions to liquidate a drugstore that was part of an estate.

[9] The store suffered a significant burglary on the morning of September 15, 1956, with looters targeting the drug selection and liquor inventory plus cash from the till.

[10] Among the inventory listed as stolen were cigarettes, electric shavers, whiskey, and writing utensils, however the store vault was not touched.

[14] The lower prices would have forced many pharmacies like the Republic Drug Store to turn away Medicaid prescriptions, stated Patty Slagle.

At the time, Slagle noted over half the prescriptions processed by Republic Drug were through Medicaid, and the store would need to consider turning patients away, which would result in a drive of anywhere from 80–100 mi (130–160 km) to reach another pharmacy.

[14][15] The family ownership of the Republic Drug Store ended in 2021 when owners Rob and Patty finalized sale to the Ferry County Hospital District in January 2021.

[16] The drug store has been transitioned to ownership and oversight of the hospital district and maintains its franchise membership with Health Mart.

[17][18] Initial opioid prescription rate reporting in a 2020 Washington Post noted that small pharmacies may have larger than average stock of drugs, many of the pills were shunted to the black market instead of legal use.

During the investigation, the DoJ recorded a number of "red flag" issues, as set out by the Controlled Substances Act that should have been seen and rectified by the attending pharmacist.

In 2023, the Ferry County Hospital District came to an agreement with the Department of Justice attorneys under Vanessa Waldref for the recorded violations.

[16] The hospital district entered into an agreement with the DoJ to increase training of the store staff and be subject to stock audits on a quarterly basis.

[22] Due to the preserved nature of the turn-of-the-century building, the Drug Store has been identified by Washington Filmworks as a potential film location.