Healthcare Provider Details

I. General information

NPI: 1649364951
Provider Name (Legal Business Name): FIDALGO PHARMACY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 COMMERCIAL AVE STE B
ANACORTES WA
98221-2232
US

IV. Provider business mailing address

1415 COMMERCIAL AVE STE B
ANACORTES WA
98221-2232
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-2374
  • Fax: 360-293-0945
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberCF56252
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN THOMPSON
Title or Position: OWNER PHARMACIST
Credential: RPH
Phone: 360-299-2374