Organization
WELL LIFE PHARMACY INCORPORATED
Active
Other names
WELL LIFE LATAH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF FOSTER RPH (OWNER)
(208) 267-4004
Entity
Organization
Contact information
Practice address
5608 S REGAL ST STE 102, SPOKANE, WA 99223-7957
(509) 838-0896
(509) 838-1085
Mailing address
PO BOX 1687, BONNERS FERRY, ID 83805-1687
(208) 267-8929
(208) 267-8085
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60586627
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110399
PK
—
05
—
6030597
—
WA
05
—
807723000
—
WA
05
—
807728700
—
ID
Enumeration date
09/06/2006
Last updated
01/18/2017
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