Organization
NORTH PINES PHARMACY INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTICH RPH (RPH/OWNER)
(509) 924-1222
Entity
Organization
Contact information
Practice address
12414 E SPRAGUE AVE, SPOKANE VALLEY, WA 99216-0722
(509) 924-1222
(509) 922-6411
Mailing address
12414 E SPRAGUE AVE, SPOKANE VALLEY, WA 99216-0722
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00003805
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4915243
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6119804
—
WA
Enumeration date
11/15/2006
Last updated
09/29/2008
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