| NPI | 1942333422 |
|---|---|
| Other Name | ID PHARMACY |
| Entity Type | Organization |
| Authorized Contact | HERMES SHAHBAZIAN CFO 206-788-3618 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA CF.60114707) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA CF00056068) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-03-29 |