| NPI | 1912677998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI LAFLEN VP Of Finance 971-206-5172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-09-20 |