| NPI | 1366595472 |
|---|---|
| Doing Business As | FOOD PAVILION #456 PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DAVE RASMUSSON Pharmacy Coordinator 360-714-7749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA CF00019389) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2009-09-09 |