| NPI | 1588939284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTE LEVAQUE R Ph/Member 360-419-0928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: WA phar.cf.60274451) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |