Organization
GIG HARBOR
Active
Other names
GIG HARBOR REXALL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LOUGREN (MANAGER)
(253) 858-9905
Entity
Organization
Contact information
Practice address
3114 JUDSON ST, GIG HARBOR, WA 98335-1222
(253) 858-9908
(253) 858-7213
Mailing address
PO BOX 406, GIG HARBOR, WA 98335-0406
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHARCF00000305
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4903971
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/04/2006
Last updated
08/23/2010
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