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Organization

LACEY SQUARE PHARMACY INC

Active
Other names
READY MEDS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANDERSON SHAWN JOLLY RPH (PRESIDENT)
(425) 251-6335
Entity
Organization

Contact information

Practice address
6020 PACIFIC AVE SE STE C, LACEY, WA 98503-1319
(425) 251-6335
(425) 251-6337
Mailing address
1412 SW 43RD ST STE 120, RENTON, WA 98057-4803
(425) 251-6335

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHAR.CF.60953133
WA PHARMACY LICENSE
WA
Enumeration date
05/22/2019
Last updated
05/22/2019
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