Organization
MILL CREEK PHARMACY INC
Active
Other names
MILL CREEK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SOMERS RPH (PRESIDENT)
(425) 481-7575
Entity
Organization
Contact information
Practice address
1025 153RD ST SE STE 104, MILL CREEK, WA 98012-4051
(425) 481-7575
(425) 338-0167
Mailing address
1025 153RD ST SE STE 104, MILL CREEK, WA 98012-4051
(425) 481-7575
(425) 338-0167
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
PHARCF00003562
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4916269
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6145601
—
WA
Enumeration date
08/31/2006
Last updated
05/06/2011
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