MEDICARE: SOAS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
2	261Q00000X	Clinic/Center
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	3336C0004X	Compounding Pharmacy	PHAR.CF.60341892	WA
5	3336L0003X	Long Term Care Pharmacy	PHAR.CF.60341892	WA
6	3336S0011X	Specialty Pharmacy	PHAR.CF.60341892	WA
7	333600000X	Pharmacy	CF60341892

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	CF60341892	OTHER	WA	STATE LICENSE

General Provider Information

NPI Number	:	1952302382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOAS, LLC

Provider Business Mailing Address
First Line	:	32170 STATE ROUTE 20
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3719
Country	:	US
Telephone Number	:	360-675-6688
Fax Number	:	360-675-1563

Provider Business Practice Location Address
First Line	:	32170 STATE ROUTE 20
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3774
Country	:	US
Telephone Number	:	360-675-6688
Fax Number	:	360-675-1563

Authorized Official
Title or Position	:	OWNER
Name	:	MR. AARON MATTHEW SYRING
Credential	:	PHARM.D.
Telephone Number	:	360-675-6688

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/07/2023

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Directions to “SOAS, LLC ” Practice Location

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