| NPI | 1487425781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZEL JANE MANONGDO BAUTISTA Pharmacist In Charge 253-272-0324 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |