Organization
DES MOINES DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY LEE MALMO RPH (PHARMACIST OWNER)
(206) 878-2345
Entity
Organization
Contact information
Practice address
627 SO 227TH ST, DES MOINES, WA 98198-6827
(206) 878-2345
(206) 878-6839
Mailing address
627 SO 227TH ST, DES MOINES, WA 98198-6827
(206) 878-2345
(206) 878-6839
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
CF00001306
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4903286
NABP
WA
05
—
6021703
—
WA
Enumeration date
11/30/2006
Last updated
02/13/2008
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