| 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 |