| NPI | 1083695324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Dir Reimb Admin & Asst Sec For Enro 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: AK PHAR355) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2018-03-28 |