# KSR HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Invara
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093274458
- **Authorized official:** SIMEON ROTH PHARMD (PHARMACY MANAGER)
- **Authorized official phone:** (360) 953-5250

## Contact information

- **Practice address:** 31111 US-2, SULTAN, WA 98294
- **Practice address phone:** (360) 953-5250
- **Practice address fax:** (360) 294-8529
- **Mailing address:** PO BOX 90, SULTAN, WA 98294-0090
- **Mailing address phone:** (360) 953-5250
- **Mailing address fax:** (360) 294-8529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/15/2019
- **Last updated:** 03/10/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2132773 | — | WA |