Organization
TLC INTEGRATIVE PHARMACY INC
Active
Other names
TLC INTEGRATIVE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRY LEFELMAN RPH (OWNER PIC)
(425) 785-4955
Entity
Organization
Contact information
Practice address
15600 NE 8TH ST, STE K8, BELLEVUE, WA 98008-3927
(425) 653-2323
(425) 653-3535
Mailing address
15600 NE 8TH ST, STE K8, BELLEVUE, WA 98008-3927
(425) 653-2323
(425) 653-3535
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
CF00058793
WA
3336C0004X
Compounding Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932162
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/28/2006
Last updated
11/09/2012
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