Organization
GEMSTATE PHARMACY GROUP INC
Active
Other names
MediCap LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIR WHITNEY (GREFFIER)
(360) 543-7376
Entity
Organization
Contact information
Practice address
800 S INDUSTRY WAY STE 330, MERIDIAN, ID 83642-3598
(208) 287-3733
(208) 258-6756
Mailing address
851 COHO WAY, SUITE 312, BELLINGHAM, WA 98225-2067
(360) 685-4270
(360) 205-7504
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
40843LS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053742577
—
ID
01
—
2157649
PK
—
Enumeration date
12/09/2013
Last updated
09/19/2025
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