Organization
CENTRALIA PHARMACY GROUP INC
Active
Other names
Chehalis Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SHANE HARRELL PHARMD (PRESIDENT/OWNER)
(360) 262-4211
Entity
Organization
Contact information
Practice address
422 S MARKET BLVD, CHEHALIS, WA 98532-3044
(360) 262-4211
(360) 996-1001
Mailing address
PO BOX B, ILWACO, WA 98624-0167
(360) 262-4211
(360) 996-1001
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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