NPI | 1710225271 |
---|---|
Doing Business As | PROVIDENCE INFUSION AND PHARM SERV |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Asst Sec For Enrollment/Dir Reimb A 425-525-5392 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 333600000X Pharmacy |
3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
Enumeration Date | 2013-01-17 |
Last Update Date | 2021-10-08 |