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Individual
PONCIANO F BAUTISTA
Active
Individual
PONCIANO F BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00017744
WA
3336C0002X
Clinic Pharmacy
PH00017744
WA
3336C0003X
Community/Retail Pharmacy
PH00017744
WA
3336C0004X
Compounding Pharmacy
PH00017744
WA
3336H0001X
Home Infusion Therapy Pharmacy
PH00017744
WA
3336I0012X
Institutional Pharmacy
PH00017744
WA
3336L0003X
Long Term Care Pharmacy
PH00017744
WA
3336M0002X
Mail Order Pharmacy
PH00017744
WA
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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