| NPI | 1720121346 |
|---|---|
| Doing Business As | PROVIDENCE INFUSION AND PHARMACY SERVICES |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WA CF00056548) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2024-06-19 |