| NPI | 1720121346 |
|---|---|
| Doing Business As | PROVIDENCE INFUSION AND PHARMACY SERVICES |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WA CF00056548) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2019-12-16 |