Organization
LJS FURNESS DRUG
Active
Other names
LJS FURNESS DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE SCHMIDT (OWNER PHCST)
(360) 425-3280
Entity
Organization
Contact information
Practice address
114 PACIFIC AVE S, KELSO, WA 98626-1616
(360) 425-3280
(360) 425-0625
Mailing address
114 PACIFIC AVE S, KELSO, WA 98626-1616
(360) 425-3280
(360) 425-0625
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.00056878
WA
3336L0003X
Long Term Care Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108511
PK
—
05
—
6005383
—
WA
Enumeration date
11/08/2006
Last updated
04/21/2016
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