Organization
SUNCREST PHARMACY GROUP, LLC
Active
Other names
Suncrest Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ERIK NELSON PHARMD (PRESIDENT)
(509) 455-9345
Entity
Organization
Contact information
Practice address
5919F HIGHWAY 291, NINE MILE FALLS, WA 99026
(509) 413-2030
(509) 413-2091
Mailing address
PO BOX B, ILWACO, WA 98624-0167
(360) 642-3133
(360) 642-5133
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2142653
—
WA
Enumeration date
06/25/2019
Last updated
11/27/2019
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