Organization
FOUNTAIN DRUG AND VARIETY INC
Active
Other names
FOUNTAIN DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN COUDRIET (PHARMACIST AND TECHNICIAN)
(360) 733-6200
Entity
Organization
Contact information
Practice address
2416 MERIDIAN ST, BELLINGHAM, WA 98225-2405
(360) 733-6200
(360) 671-4644
Mailing address
2416 MERIDIAN ST, BELLINGHAM, WA 98225-2405
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00002219
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4902296
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
6003784
—
WA
Enumeration date
02/15/2007
Last updated
07/20/2007
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