| NPI | 1235271701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secreatry For Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: WA FL00056502) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2025-07-08 |