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Organization

BROKEN OAK LLC

Active
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Organization

BROKEN OAK LLC

Active
Other names
NorthStar Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DR. APRIL M RUSSELL PHARM.D. (OWNER)
(509) 740-0833
Entity
Organization

Contact information

Practice address
208 S MAIN ST, OMAK, WA 98841-9755
(509) 740-0833
Mailing address
PO BOX 265, OKANOGAN, WA 98840-0265
(509) 846-4910

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
183700000X
Pharmacy Technician
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
07/03/2020
Last updated
07/03/2020
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