| |
2539 Marvin Rd Ne Ste E Lacey WA 98516-3177 | |
(360) 438-3072 | |
(360) 438-3532 |
Full Name | |
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Speciality | Pharmacy |
Location | 2539 Marvin Rd Ne, Lacey, Washington |
Authorized Official Name and Position | Sunil B Thimmegowda (OWNER/PHARMACIST) |
Authorized Official Contact | 3604383072 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2539 Marvin Rd Ne Ste E Lacey WA 98516-3177 Ph: (360) 438-3072 | 2539 Marvin Rd Ne Ste E Lacey WA 98516-3177 Ph: (360) 438-3072 |
NPI Number | 1508292707 |
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Provider Enumeration Date | 09/19/2013 |
Last Update Date | 11/11/2023 |
Medicare PECOS PAC ID | 7416184783 |
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Medicare Enrollment ID | O20131211001364 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508292707 | NPI | - | NPPES |
G8924654 | Other | WA | MEDICARE MASS IMMUNIZATION |
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