NPI | 1356962385 |
---|---|
Doing Business As | PROVIDENCE TARZANA PHARMACY |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2020-04-30 |
Last Update Date | 2020-04-30 |