Healthcare Provider Details

I. General information

NPI: 1992726954
Provider Name (Legal Business Name): FIFE DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 PACIFIC HWY E
FIFE WA
98424-2601
US

IV. Provider business mailing address

5303 PACIFIC HWY E
FIFE WA
98424-2601
US

V. Phone/Fax

Practice location:
  • Phone: 253-922-0222
  • Fax: 253-926-2541
Mailing address:
  • Phone: 253-922-0222
  • Fax: 253-926-2541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberCF00002473
License Number StateWA

VIII. Authorized Official

Name: DAVID MORIO
Title or Position: PRESIDENT
Credential:
Phone: 253-922-0222