Organization
LINCOLN COUNTY HEALTHMART PHARM
Active
Other names
LINCOLN COUNTY HEALTHMART PHARM
Organization subpart
No
Provider details
NPI number
Authorized official
TOM PAUL PHARM (OWNER)
(509) 725-3310
Entity
Organization
Contact information
Practice address
621 MORGAN ST, DAVENPORT, WA 99122-5015
(509) 725-3310
(509) 725-3320
Mailing address
PO BOX 458, DAVENPORT, WA 99122-0458
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00003505
WA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106601
PK
—
05
—
6045306
—
WA
Enumeration date
10/25/2006
Last updated
01/18/2017
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