Chinook Pharmacy Clinical | |
11 S Forks Ave Ste A Forks WA 98331-9006 | |
(360) 374-2294 | |
(360) 374-5057 |
Full Name | Chinook Pharmacy Clinical |
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Speciality | Family Medicine |
Location | 11 S Forks Ave Ste A, Forks, Washington |
Authorized Official Name and Position | Charles Edward Carlson (OWNER/RPH) |
Authorized Official Contact | 3603742294 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chinook Pharmacy Clinical Po Box 2136 Forks WA 98331-2136 Ph: (360) 374-2294 | Chinook Pharmacy Clinical 11 S Forks Ave Ste A Forks WA 98331-9006 Ph: (360) 374-2294 |
NPI Number | 1417528282 |
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Provider Enumeration Date | 07/02/2021 |
Last Update Date | 07/02/2021 |
Identifier | Type | State | Issuer |
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1417528282 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |