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Organization

PENINSULA PHARMACIES INC

Active
Other names
Long Beach Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY SHANE HARRELL (PRESIDENT)
(360) 244-5984
Entity
Organization

Contact information

Practice address
101 BOLSTAD AVE, LONG BEACH, WA 98631
(360) 642-2349
(360) 642-8786
Mailing address
PO BOX 187, 101 BOLSTAD AVE, LONG BEACH, WA 98631
(360) 642-2349
(360) 642-8786

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
CF00000497
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6085609
WA
Enumeration date
10/19/2006
Last updated
05/12/2022
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