Organization
PENINSULA PHARMACIES INC.
Active
Other names
Ilwaco Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SHANE HARRELL (PRESIDENT)
(360) 642-3133
Entity
Organization
Contact information
Practice address
101 1ST AVE S, ILWACO, WA 98624-9100
(360) 642-3133
(360) 642-5133
Mailing address
PO BOX B, ILWACO, WA 98624-0167
(360) 642-3133
(360) 642-5133
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
12/16/2020
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