| NPI | 1518504984 |
|---|---|
| Doing Business As | COLUMBIA COMPOUNDING |
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER PETERSEN Managing Member 360-261-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2020-02-21 |