Organization
W DALE GROSS
Active
Other names
GROSS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER GROSS (OWNER AND PHCIST)
(509) 686-5191
Entity
Organization
Contact information
Practice address
2520 FOSTER AVE, BRIDGEPORT, WA 98813-1029
(509) 686-5191
(509) 686-2807
Mailing address
PO BOX 1029, BRIDGEPORT, WA 98813-1029
(509) 686-5191
(509) 686-5191
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHARCF00000329
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106566
PK
—
05
—
6145700
—
WA
Enumeration date
01/30/2007
Last updated
02/20/2014
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