| NPI | 1235271701 |
|---|---|
| Doing Business As | PROVIDENCE MOTHER JOSEPH CARE CENT |
| Entity Type | Organization |
| Authorized Contact | CRAIG STEVEN WYNN Pharmacy Manager 360-493-4572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WA FL00056502) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2023-03-07 |