Organization
WA VETERANS HOME PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE WESTHOFF (CFO)
(360) 725-2171
Entity
Organization
Contact information
Practice address
1141 BEACH DR E, RETSIL, WA 98378
(360) 895-4700
(360) 895-4452
Mailing address
1141 BEACH DR E, PORT ORCHARD, WA 98366-4937
(360) 895-4700
(360) 895-4453
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
FL00001169
WA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4906092
NADP
WA
01
—
4906092
NABP
—
05
—
6015010
—
WA
Enumeration date
03/20/2007
Last updated
09/28/2020
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