Organization
DES MOINES DRUG STORE INC
Active
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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