| NPI | 1437256278 |
|---|---|
| Doing Business As | SOUTH PARK PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KENNETH PASKETT Owner 360-871-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA PHARCF00000804) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-05-04 |