| NPI | 1104513811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH STILL Enrollment Specialist 206-744-9888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-04-21 |