Organization
NORTHWEST PHARMACY SERVICES INC
Active
Other names
Sid's LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WIL EDWARDS (OWNER)
(208) 875-1212
Entity
Organization
Contact information
Practice address
825 SE BISHOP BLVD STE 301B, PULLMAN, WA 99163-5517
(509) 334-6506
(509) 334-4776
Mailing address
825 SE BISHOP BLVD STE 301B, PULLMAN, WA 99163-5517
(509) 332-4608
(509) 334-4776
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHAR.CF.60432154
WA
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2035300
—
WA
01
—
2144904
PK
—
Enumeration date
02/18/2014
Last updated
02/16/2023
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