Organization
WMSO LLC
Active
Other names
Holladay Drug #1139
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WINFIELD F MUFFETT III RPH (OWNER)
(360) 693-5879
Entity
Organization
Contact information
Practice address
39 S HOLLADAY DR, SEASIDE, OR 97138-6716
(503) 738-5362
(503) 717-0325
Mailing address
916 W EVERGREEN BLVD, VANCOUVER, WA 98660-3035
(360) 213-2236
(360) 213-2238
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
4754300001
OR
333600000X
Pharmacy
Primary
IP0002147CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234858
—
OR
01
—
3814983
NCPDP
—
Enumeration date
03/22/2006
Last updated
11/20/2009
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