| NPI | 1427132265 |
|---|---|
| Doing Business As | PROVIDENCE SPECIALTY PHARMACY SERVICES-INFUSION/SPP |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Corp Secretary For Enrollments 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: OR RP-0001136-CS) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: OR RP-0001136-CS) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-05-06 |