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Contact Information

SUNCREST PHARMACY GROUP, LLC
5919F HIGHWAY 291
NINE MILE FALLS, WA99026
 Phone: 509-413-2030
 Fax: 509-413-2091
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SUNCREST PHARMACY GROUP, LLC

NPI # 1669033288
LBN Legal business name SUNCREST PHARMACY GROUP, LLC
Authorized official ERIK NELSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/25/2019
Last updated 11/27/2019 - About 7 years ago
Identifiers
WA Medicaid 2142653
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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