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Organization
KSR HEALTH CARE LLC
Active
Organization
KSR HEALTH CARE LLC
Active
Other names
Invara
Organization subpart
No
Provider details
NPI number
Authorized official
SIMEON ROTH PHARMD (PHARMACY MANAGER)
(360) 953-5250
Entity
Organization
Contact information
Practice address
31111 US-2, SULTAN, WA 98294
(360) 953-5250
(360) 294-8529
Mailing address
PO BOX 90, SULTAN, WA 98294-0090
(360) 953-5250
(360) 294-8529
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
Primary
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2132773
—
WA
Enumeration date
03/15/2019
Last updated
03/10/2022
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