| NPI | 1508972456 |
|---|---|
| Doing Business As | PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: CA HSP47226) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-10-20 |