Organization
WILLAPA HARBOR PHARMACIES INC
Active
Other names
SOUTH BEND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE COX (OWNER)
(360) 875-5757
Entity
Organization
Contact information
Practice address
101 WILLAPA AVE, SOUTH BEND, WA 98586
(360) 875-5757
(360) 875-6021
Mailing address
PO BOX 395, SOUTH BEND, WA 98586-0395
(360) 875-5757
(360) 875-6021
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF.60061411
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107430
PK
—
05
—
6107007
—
WA
Enumeration date
11/03/2006
Last updated
05/03/2018
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