| NPI | 1770589129 |
|---|---|
| Doing Business As | NORTHWOODS LODGE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DAVID SMITH Rx Manager 360-698-3930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WA PHAR.CF.60295845) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2014-06-19 |