Organization
COLUMBIA RIVER PHARMACY
Active
Other names
Malley's Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HENRIKSEN PHARMD (OWNER)
(509) 943-9173
Entity
Organization
Contact information
Practice address
1906 GEORGE WASHINGTON WAY, RICHLAND, WA 99354-2308
(509) 943-9173
(509) 946-1122
Mailing address
1906 GEORGE WASHINGTON WAY, RICHLAND, WA 99354-2308
(509) 943-9173
(509) 946-1122
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60176819
WA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106368
PK
—
05
—
6143903
—
WA
Enumeration date
07/06/2006
Last updated
01/15/2016
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