| NPI | 1235233289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN FARIS PIC 360-685-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: WA FL00058443) |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-08-22 |