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Suppliers Pharmacy Long Term Care Pharmacy

Provider NPI: 1104207372

Organization Information:
Organization is not Subpart
Authorized Official:  RANDALL  JOHNSON  OWNER/PHARMACIST  509-539-2709

Practice Location:
800 SWIFT BLVD STE 140  RICHLAND, WA 99352-3559 US
Tel: 509-713-7444  Fax: 509-713-7422

Business Mailing Address:
Tel: 509-713-7444  Fax: 509-713-7422

NPI Information:
NPI: 1104207372
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Long Term Care Pharmacy

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 3336C0003X





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