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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