Healthcare Provider Details

I. General information

NPI: 1508960550
Provider Name (Legal Business Name): PURDY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14218 92ND AVE NW
GIG HARBOR WA
98329-8710
US

IV. Provider business mailing address

14218 92ND AVE NW
GIG HARBOR WA
98329-8710
US

V. Phone/Fax

Practice location:
  • Phone: 253-857-7944
  • Fax: 253-857-7679
Mailing address:
  • Phone: 253-857-7944
  • Fax: 253-857-7679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberCF00002916
License Number StateWA

VIII. Authorized Official

Name: JEFFREY S HARRELL
Title or Position: OWNER
Credential: PHARMD
Phone: 360-244-5984