Organization
LJS FURNESS DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY M FJERMESTAD (MANAGER)
(360) 425-3280
Entity
Organization
Contact information
Practice address
114 PACIFIC AVE S, KELSO, WA 98626-1699
(360) 425-3280
(360) 425-0625
Mailing address
114 PACIFIC AVE S, KELSO, WA 98626-1699
(360) 425-3280
(360) 425-0625
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005383
—
WA
Enumeration date
08/09/2019
Last updated
08/09/2019
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