Organization
SIDS PROFESSIONAL PHARMACY
Active
Other names
SID'S LTC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SIDNEY PIERSON (PHARMASIST)
(509) 332-4608
Entity
Organization
Contact information
Practice address
825 SE BISHOP BLVD STE 301B, PULLMAN, WA 99163-5517
(509) 332-4608
Mailing address
825 SE BISHOP BLVD STE 301B, PULLMAN, WA 99163-5517
(509) 332-4608
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
CF.60065572
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4933481
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/20/2009
Last updated
05/27/2010
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