| NPI | 1295928349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE JASON Contracts Administrator 253-218-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: KY P07131) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07131) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2008-03-03 |