| NPI | 1780828327 |
|---|---|
| Other Name | PROVIDENCE SMMC PHARMACY DME |
| Entity Type | Organization |
| Authorized Contact | SUSAN A COLUMBER Rcm Director 509-522-5906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WA PHAR.CF.00001050) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |