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A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Clinic Pharmacy |
3336C0002X | 58 | Medical Supply Company with Pharmacist | |
Clinical Pharmacology |
208U00000X | |||
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Compounding Pharmacy |
3336C0004X | 58 | Medical Supply Company with Pharmacist | |
Home Infusion Therapy Pharmacy |
3336H0001X | 58 | Medical Supply Company with Pharmacist | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist | |
Specialty Pharmacy |
3336S0011X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1720121346 |
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| LBN Legal business name | PROVIDENCE HEALTH & SERVICES WASHINGTON | ||||
| Authorized official | DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 02/14/2007 | ||||
| Last updated | 05/16/2025 - More than a year ago | ||||
| Identifiers |
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PROVIDENCE HEALTH & SERVICES WASHINGTON
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PROVIDENCE HEALTH & SERVICES WASHINGTON