Organization
KIRKS DRUG INC
Active
Other names
Kirks at BHR
Organization subpart
No
Provider details
NPI number
Authorized official
JIM RODGERS (GENERAL MANAGER)
(360) 456-5475
Entity
Organization
Contact information
Practice address
4422 6TH AVE SE, LACEY, WA 98503-1020
(360) 456-2030
(360) 456-2318
Mailing address
4422 6TH AVE SE, LACEY, WA 98503-1020
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
60062942
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4933164
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6016646
—
WA
Enumeration date
01/22/2009
Last updated
02/18/2009
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