Organization
HALCYON RX INC
Active
Organization
HALCYON RX INC
Active
Other names
MEDICINE MAN LIBERTY LAKE
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN AMINI RPH (OWNER AND PHARMACIST)
(509) 755-3333
Entity
Organization
Contact information
Practice address
23801 E APPLEWAY AVE, STE 260B, LIBERTY LAKE, WA 99019-9687
(509) 755-3333
(509) 755-3337
Mailing address
23801 E APPLEWAY AVE, STE 260B, LIBERTY LAKE, WA 99019-9687
(509) 755-3333
(509) 755-3337
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
FL0341254
WA
3336C0004X
Compounding Pharmacy
FL0341254
WA
3336L0003X
Long Term Care Pharmacy
Primary
FL0341254
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4931463
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
6024178
—
WA
Enumeration date
09/12/2006
Last updated
02/12/2008
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