| NPI | 1316026297 |
|---|---|
| Doing Business As | MEDICAL LAKE OWL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | AMANDA GOYKE Owner/ President 509-235-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WA PHARCF00001876) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2024-03-11 |