Organization
CLEARBROOK LODGE INC
Active
Other names
NORTHWOODS LODGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SMITH (RX MANAGER)
(360) 698-3930
Entity
Organization
Contact information
Practice address
2321 NW SCHOLD PL, SILVERDALE, WA 98383-9504
(360) 698-3930
(360) 307-9562
Mailing address
2321 NW SCHOLD PL, SILVERDALE, WA 98383-9504
(360) 698-3930
(360) 307-9562
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHAR.CF.60295845
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110559
PK
—
Enumeration date
06/21/2005
Last updated
06/19/2014
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