Organization
CREDENA HEALTH LLC
Active
Other names
Credena Health Pharmacy Centralia
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE SKAFI (AVP/SECRETARY)
(575) 650-3396
Entity
Organization
Contact information
Practice address
1800 COOKS HILL RD STE P, CENTRALIA, WA 98531-9162
(360) 827-7997
Mailing address
PO BOX 2704, PORTLAND, OR 97208-2704
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60659119
WA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108230
PK
—
Enumeration date
10/11/2006
Last updated
05/31/2024
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