Organization
MIPA CORP
Active
Other names
Pharmacy Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANNABELLE LEE RPH (OWNER, PHCY MGR, PIC)
(425) 743-2211
Entity
Organization
Contact information
Practice address
4629 168TH ST SW STE A, LYNNWOOD, WA 98037-8640
(425) 743-2211
(425) 743-2002
Mailing address
4629 168TH ST SW STE A, LYNNWOOD, WA 98037-8640
(425) 743-2211
(425) 743-2002
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF60129305
WA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117385
PK
—
05
—
6031983
—
WA
Enumeration date
08/08/2008
Last updated
04/15/2015
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