Organization
NATIVE PROJECT PHARMACY
Active
Organization
NATIVE PROJECT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI LODGE (CEO)
(509) 325-5502
Entity
Organization
Contact information
Practice address
1803 W MAXWELL AVE, SPOKANE, WA 99201-2831
(509) 325-5502
Mailing address
1803 W MAXWELL AVE, SPOKANE, WA 99201-2831
(509) 325-5502
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
601182805
WA
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
601182805
WA
3336C0002X
Clinic Pharmacy
601182805
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2039882
—
WA
Enumeration date
10/14/2016
Last updated
10/14/2016
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