| NPI | 1053742577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIR WHITNEY Greffier 360-543-7376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: ID 40843LS) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2018-07-19 |